Clinicopathological findings and imaging features of intraductal papillary neoplasm of the bile duct: comparison between contrast-enhanced ultrasound and contrast-enhanced computed tomography
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Intraductal papillary neoplasms of the bile duct (IPNBs) are a group of rare lesions with uncertain clinical findings and imaging features. We aim to investigate the clinicopathological features and imaging findings of IPNBs on contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT).
From February 2005 to March 2018, 30 patients with pathologically confirmed IPNBs were retrospectively identified in our hospital. Demographic, clinical, and pathological data, CEUS and CECT features and surgical strategies were analyzed.
The most common clinical manifestations were abdominal pain (53.3%), jaundice (23.3%), and acute cholangitis (10.0%). Among all lesions, 5/30 (16.7%) lesions presented as dilated bile ducts only, while 13/30 (43.3%) lesions presented as dilated bile ducts with intraductal papillary masses, and 12/30 (40.0%) presented as solid masses with dilated bile ducts. For the 20 patients who underwent both CEUS and CECT, 18 lesions were hyperenhanced on CEUS, and 17 lesions were hyperenhanced on CECT in the arterial phase. In total, 16 and 18 lesions showed washout in the portal and late phases on CEUS, while the corresponding number of lesions that showed washout in the portal and late phases on CECT were 11 and 13. Twelve lesions (40.0%) showed atypical hyperplasia, while 16/30 (53.3%) lesions underwent malignant transformations.
There are 3 major forms of IPNBs on grayscale ultrasound, including diffusely dilated bile ducts without visible mass; focal dilated bile duct with intraductal papillary masses; and solid mass surrounded by dilated bile ducts. The enhancement patterns of IPNBs on CEUS and on CECT were consistent. IPNB has a high malignant potential, and patients should be treated with surgical resection after the diagnosis is established.
KeywordsIntraductal papillary neoplasms of the bile duct Clinicopathological features Contrast-enhanced ultrasound Contrast-enhanced computed tomography
Intraductal papillary neoplasms of the bile duct
Contrast-enhanced computed tomography
Contrast pulse sequencing
Contrast harmonic imaging
Carbohydrate antigen 125
Carbohydrate antigen 19-9
Financial Support: This study was funded by the National Nature Science Foundation of China (NO.81701701), Guangdong Nature Science Foundation (NO.2017A030313661,NO. 2016A030310143), Guangdong science and technology plan project (NO. 2017A020215195), Sun Yat-sen University young teachers training project(NO. 16YKPY37).
Wei Wang and Bing Liao designed the research. Quan-Yuan Shan collected data; Ming Xu and Li-Da Chen evaluated the images and videos of US and CT. Hang-Tong Hu analyzed the data; Yang Huang edited tables and Figures; Qiao Zheng and Si-Min Ruan wrote the paper; Xiao-Yan Xie and Ming-De Lu edited the paper and polished the language.
Compliance with ethical standards
Conflict of interest
The author declare that they have no competing interest.
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