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Clinicopathological findings and imaging features of intraductal papillary neoplasm of the bile duct: comparison between contrast-enhanced ultrasound and contrast-enhanced computed tomography

  • Hepatobiliary
  • Published:
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Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

IPNB:

Intraductal papillary neoplasms of the bile duct

CEUS:

Contrast-enhanced ultrasound

CECT:

Contrast-enhanced computed tomography

ICC:

Intrahepatic cholangiocarcinoma

CPS:

Contrast pulse sequencing

CHI:

Contrast harmonic imaging

CA125:

Carbohydrate antigen 125

CA19-9:

Carbohydrate antigen 19-9

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Acknowledgements

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).

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Author notes

  1. Qiao Zheng and Si-Min Ruan are Co-first authors.

Authors and Affiliations

  1. Department of Medical Ultrasonics, Fetal Medical Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China

    Qiao Zheng

  2. Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Si-Min Ruan, Quan-Yuan Shan, Ming Xu, Li-Da Chen, Hang-Tong Hu, Yang Huang, Xiao-Yan Xie, Ming-De Lu & Wei Wang

  3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China

    Ming-De Lu

  4. Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, People’s Republic of China

    Bing Liao

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Contributions

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.

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Correspondence to Bing Liao or Wei Wang.

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Zheng, Q., Ruan, SM., Shan, QY. et al. Clinicopathological findings and imaging features of intraductal papillary neoplasm of the bile duct: comparison between contrast-enhanced ultrasound and contrast-enhanced computed tomography. Abdom Radiol 44, 2409–2417 (2019). https://doi.org/10.1007/s00261-019-01987-4

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  • DOI: https://doi.org/10.1007/s00261-019-01987-4

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