To investigate the ultrasonography and clinicopathology features of intrahepatic bile duct adenoma (BDA).
Methods:
Six patients with BDA diagnosed by biopsy and surgery pathology in Zhongshan Hospital and Xiamen Branch
Fudan University from January 2019 to July 2021 were analyzed for the characteristics of conventional ultrasound and contrast-enhanced ultrasound (CEUS)
and their characteristics were summarized in combination with the clinical and pathological manifestations.
Results:
There were 9 lesions in 6 patients
all of which were located under the liver capsule. The maximum lesion size was 12 mm10 mm and the minimum lesion size was 6 mm5 mm. In 2 of the 9 lesions
hyper echo appeared in the center
surrounded by low echo ring
similar to the target ring sign
which had a certain correlation with pathology. Three lesions were clearly demarcated
and six lesions were poorly or ill-demarcated. There was no obvious color blood flow in Doppler ultrasound. CEUS showed rapid overall enhancement in six lesions and synchronous enhancement in three lesions. All of the 9 lesions showed rapid entry and rapid exit in the late arterial or portal phase. Three benign lesions and six malignant lesions were diagnosed by ultrasonography
and the accuracy was 33.3%. Pathologically
a large number of proliferative bile ducts can be seen in this disease
accompanied by extensive chronic inflammatory cell infiltration
and the bile duct epithelium is well differentiated. With the progressof the disease
the proliferative bile ducts and infiltrating inflammatory cells in the lesion gradually decrease
while the fibrous tissue gradually increases.
Conclusion:
Ultrasonography and clinicopathology of BDA have certain characteristics
and it is helpful to understand BDA and improve the diagnostic accuracy.