Objective To conclude the intraductal
ultrasonography ( IDUS ) characteristics of
cholangiocarcinoma and improve endoscopic
diagnosis for
cholangiocarcinoma by comparing manifestations of IDUS between
cholangiocarcinoma and benign
bile duct stricture.
Methods A total of 52
patients undergoing
endoscopic retrograde cholangiopancreatography (
ERCP ) and IDUS with definite
diagnosis of
cholangiocarcinoma from January 2012 to January 2017 were included in this
retrospective study, and 59
patients undergoing
ERCP and IDUS during the same period with definite
diagnosis of benign
bile duct stricture were included as control. Clinical data, indices of
laboratory tests, and manifestations of IDUS ( including length of
stricture, echo feature, thickness of
bile duct, symmetry, and integrity of outer
membrane of
bile duct wall) were collected and compared between the two groups. Results The clinical manifestations and results of
laboratory examination showed no significant differences between the two groups. Intraductal brushing
cytology and
forceps biopsy showed 28. 9% and 40. 0% malignant evidence respectively. IDUS showed thicker
bile duct in the
cholangiocarcinoma group (6. 8±4. 0 mm VS 4. 1±2. 3 mm, P<0. 01). Proportion of hypoechoic and nonsymmetrical thickened
bile duct was higher in the
cholangiocarcinoma group( 78. 8% VS 44. 1%, 92. 3% VS 50. 8%, respectively, all P<0. 01 ) . Outer
membrane of
bile duct destruction occurred in 8 cases ( 15. 4%) in the
cholangiocarcinoma group, whereas none was seen in the
control group. Conclusion Hypoecho and nonsymmetrical thickness on IDUS may be
indicators of
cholangiocarcinoma, and destruction of
bile duct outer
membrane is highly suggestive of
cholangiocarcinoma.