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Morphological classification of intraductal papillary neoplasm of the bile duct

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the morphological classification of intraductal papillary neoplasm of the bile duct (IPNB), as well as morphological differences between IPNB without mucin secretion (IPNB-NM) and IPNB with mucin secretion (IPMN-B).

Methods

Eighty-one patients with IPNB were retrospectively analysed. Imaging examinations included computed tomography (CT), magnetic resonance imaging (MRI), gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI and positron emission tomography–computed tomography (PET-CT). According to the morphology of tumours and extent of bile duct dilations, IPNB was classified into seven types: I, upstream-ductectatic type; II, typical type; III, superficial-spreading type; IV, no-mass-forming type; V, intrahepatic-cystic type; VI, extrahepatic-cystic type; and VII, infiltrating type.

Results

Thirteen IPNB-NM patients comprised type I (11 cases), type II (1 case) and type VII (1 case); 68 IPMN-B patients comprised type I (2 cases), type II (30 cases), type III (6 cases), type IV (11 cases), type V (13 cases), type VI (2 cases) and type VII (4 cases). Bile duct dilations were more severe in IPMN-B than in IPNB-NM. PET-CT and Gd-EOB-DTPA-enhanced MRI clearly demonstrated the extension of infiltrating IPNB.

Conclusions

IPNB can be classified into seven morphological types. IPNB-NM and IPMN-B have different morphological features.

Key Points

• IPNB can be classified into seven morphological types.

• IPNB-NM and IPMN-B have different morphological features.

• Enhanced CT and MRI can display different types of IPNB.

• Morphological classification of IPNB facilitates management of the disease.

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Abbreviations

CT:

Computed tomography

DWI:

Diffusion-weighted image

ERCP:

Endoscopic retrograde cholangiopancreatography

Gd-DTPA:

Gadolinium-diethylenetriaminepentaacetic acid

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid

IPMN-B:

Intraductal papillary mucinous neoplasm of the bile duct

IPNB:

Intraductal papillary neoplasm of the bile duct

IPNB-NM:

IPNB without mucin secretion

MRCP:

Magnetic resonance cholangiopancreatography

MRI:

Magnetic resonance imaging

PET-CT:

Positron emission tomography–computed tomography

T2WI:

T2-weighted image

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, China

    Shihong Ying, Wenjie Liang, Qidong Wang, Feng Chen & Wenbo Xiao

  2. Department of Radiology, Jinhua Municipal Central Hospital, 365 Renmin Dong Road, Jinhua, 321000, China

    Mingliang Ying

  3. Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, China

    Zhaoming Wang

Authors
  1. Shihong Ying
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  2. Mingliang Ying
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  3. Wenjie Liang
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  4. Zhaoming Wang
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  5. Qidong Wang
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  6. Feng Chen
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  7. Wenbo Xiao
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Corresponding author

Correspondence to Wenbo Xiao.

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Guarantor

The scientific guarantor of this publication is Wenbo Xiao.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work received fund of National Natural Science Foundation of China, No. 81171388, and partly from Zhejiang Provincial Natural Science Foundation of China, No. Z16H180003.

Statistics and biometry

One of the authors (Ying) has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was waived by the institutional review board.

Study subjects or cohorts overlap

Five patients in this study who underwent Gd-EOB-DTPA-enhanced MRI have already been reported in a previous work [26]. Nevertheless, image analyses are wholly unique to the current study.

Methodology

Retrospective, cross-sectional study/diagnostic or prognostic study/observational, performed at one institution.

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Ying, S., Ying, M., Liang, W. et al. Morphological classification of intraductal papillary neoplasm of the bile duct. Eur Radiol 28, 1568–1578 (2018). https://doi.org/10.1007/s00330-017-5123-2

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  • DOI: https://doi.org/10.1007/s00330-017-5123-2

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