Imaging Features of Premalignant Biliary Lesions and Predisposing Conditions with Pathologic Correlation

作者：Maria Zulfiqar, Deyali Chatterjee, Norihide Yoneda, Mark J. Hoegger, Maxime Ronot, Elizabeth M. Hecht, Nina Bastati, Ahmed Ba‐Ssalamah, Mustafa R. Bashir, Kathryn J. Fowler · 发表于：Radiographics · 年份：2022 · DOI：10.1148/rg.210194 · 被引用次数：24 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Pediatric Hepatobiliary Diseases and Treatments、Gallbladder and Bile Duct Disorders

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 neopl...