胆管乳头状黏液性肿瘤的超声图像特征

Ultrasonic characteristics of intraductal papillary mucinous neoplasm of the bile duct

目的探讨胆管乳头状黏液性肿瘤（intraductal papillary mucinous neoplasm of the bile duct，IPMN-B）的声像图特征，评价超声对IPMN-B的诊断价值。方法回顾性分析17例IPMN-B患者的超声图像，总结其声像图特征，与手术及病理检查结果进行对照。结果IPMN-B的声像图特征为：①胆管壁上可见肿块突向胆管腔内，呈乳头状或息肉样；②左右肝内胆管不对称性扩张，即患侧胆管明显扩张，而健侧胆管无明显扩张或仅轻度扩张；③典型者可见胆管内黏液沿胆管分布，不伴声影，不可移动，位置表浅者可见胆管内絮状黏液呈胶冻样随探头振动而轻微飘动，此为超声诊断IPMN-B的较可靠征象。结论超声对诊断IPMN-B有重要价值。

ObjectiveTo explore the ultrasound characteristics of intraductal papillary mucinous neoplasm of the bile duct（IPMN-B） and evaluate its diagnostic value.MethodsSeventeen cases of IPMN-B were diagnosed by ultrasonic examination and confirmed by surgery and pathology. The ultrasound findings and distribution of color Doppler flow signals were observed and analyzed in comparison with the surgical and pathological results. ResultsUltrasound revealed the characteristics of IPMN-B： ①Bile duct mural nodules that looked like papillary or polypoid were observed; ②Asymmetry bile duct dilatation, namely obvious dilatation in the lesion intrahepatic bile duct, but only mild dilatation in the normal intrahepatic bile duct; ③Typical lesions showed mucus in bile duct along bile duct wall without acoustic shadow or move. High frequency ultrasound revealed that mucus in bile duct could float that looked like gelatin when operator vibrated probe in those superficial lesions. This is reliable characteristics of IPMN-B by ultrasound. ConclusionsUltrasound is of high value in the diagnosis of IPMN-B.