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Erschienen in:
14.11.2017 | Hepatobiliary-Pancreas
Morphological classification of intraductal papillary neoplasm of the bile duct
Erschienen in: European Radiology | Ausgabe 4/2018
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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.