医学
胆囊
胆总管囊肿
恶性肿瘤
胆管
导管内乳头状粘液性肿瘤
肝病学
肝内胆管结石
胃肠病学
门(解剖学)
壶腹
瓦特壶腹
肝内胆管
内科学
放射科
病理
癌
囊肿
肝切除术
胰腺
外科
切除术
作者
Mustafa R. Bashir,Deyali Chatterjee,Norihide Yoneda,Mark J. Hoegger,Maxime Ronot,Elizabeth M. Hecht,Nina Bastati,Ahmed Ba‐Ssalamah,Mustafa R. Bashir,Kathryn J. Fowler
出处
期刊:Radiographics
[Radiological Society of North America]
日期:2022-09-01
卷期号:42 (5): 1320-1337
被引量:7
摘要
Biliary malignancies include those arising from the intrahepatic and extrahepatic bile ducts as well as the gallbladder and hepatopancreatic ampulla of Vater. The majority of intrahepatic and extrahepatic malignancies are cholangiocarcinomas (CCAs). They arise owing to a complex interplay between the patient-specific genetic background and multiple risk factors and may occur in the liver (intrahepatic CCA), hilum (perihilar CCA), or extrahepatic bile ducts (distal CCA). Biliary-type adenocarcinoma constitutes the most common histologic type of ampullary and gallbladder malignancies. Its prognosis is poor and surgical resection is considered curative, so early detection is key, with multimodality imaging playing a central role in making the diagnosis. There are several risk factors for biliary malignancy as well as predisposing conditions that increase the risk; this review highlights the pertinent imaging features of these entities with histopathologic correlation. The predisposing factors are broken down into three major categories: (a) congenital malformations such as choledochal cyst and pancreaticobiliary maljunction; (b) infectious or inflammatory conditions such as parasitic infections, hepatolithiasis, primary sclerosing cholangitis, and porcelain gallbladder; and (c) preinvasive epithelial neoplasms such as biliary intraepithelial neoplasm, intraductal papillary neoplasm of the bile duct, intra-ampullary papillary tubular neoplasm, and intracholecystic papillary neoplasm of the gallbladder. Recognizing the baseline features of these premalignant biliary entities and changes in their appearance over time that indicate the advent of malignancy in high-risk patients can lead to early diagnosis and potentially curative management. An invited commentary by Volpacchio is available online.Online supplemental material is available for this article.©RSNA, 2022.
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