Imaging features of intraductal papillary neoplasm of the bile duct / 中华放射学杂志

ABSTRACT

Objective To investigate the CT and MRI features of intraductal papillary neoplasm of the bile duct (IPNB).Methods Thirty eight patients with IPNB finally diagnosed by puncture biopsy or surgery were enrolled in this study.All the CT or MRI data were investigated retrospectively.Twenty one patients underwent CT examinations,17 patients underwent MRI examinations.The features of IPNB including the distribution features of the nodules or masses,CT and MRI features of cholangiectasis,mucus were analyzed.The accuracy differences of CT and MRI for the preoperatively diagnosing mucus and tumor growing along mucous were compared by nonparametric test.Results The lesions (including 5 patients with solitary lesions and 19 patients with multiple lesions) were located in intrahepatic bile duct in 24 patients,3 patients occurred simultaneously in intrahepatic and portal bile duct,2 lesions occurred in portal bile duct,8 lesions occurred in common bile duct,the lesions of 1 patient occurred simultaneously in common bile duct,cystic duct and gallbladder.Seventeen and 11 patients appeared nodules locating in dilated bile duct on CT and MRI,respectively.Four and 5 patients appeared cystic lesions with multiple nodules of the liver on CT and MRI,respectively.Higher contrast enhancement on CT and MRI in arterial phase than that in portal vein and equilibrium phase were observed in 18 and 12 patients,respectively.Excluding the patients undergoing puncture,CT was better than MRI in evaluating whether the mucus was present,with the accuracies of 30.0％ (6/20) and 6.3％ (1/16) for CT and M RI,respectively (Z =2.58,P ＜ 0.05).CT was worse than MRI in preoperatively evaluating the features of tumor growing along mucous,with the accuracies of 77.8％ (14/18) and 92.6％ (13/14) for CT and MRI,respectively (Z =4.23,P ＜ 0.01).Conclusion IPNB had the features of growing along mucous of the bile duct,nodule or mass in dilated bile duct and other features,CT and MRI are important in diagnosing the IPNB.