MRI Diagnosis and Preoperative Assessment of Type Ⅰ Congenital Choledochocele and Its Complications_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIA Jindong , SONG Bin , ZHOU Xiangping

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Magnetic resonance imaging; Congenital choledochocele; Complications

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Objective 　To investigate the value of magnetic resonance (MR) imaging for diagnosing typeⅠ congenital choledochocele and its complications.
Methods 　The MR imaging data of 13 cases with proved typeⅠ congenital choledochocele associated with complications were retrospectively reviewed and compared with operative findings. MR imaging sequences included axial T2W and T1W plain scan, true-FISP coronal images, 2D-MRCP, and Gd-enhanced T1W images.
Results 　All patients had cystic dilatation of the common bile ducts to various degrees. In 6 patients complicated with stone and infection, the bile duct showed uniform wall thickening with marked enhancement, and calculus were depicted within the duct lumen with dilatation of the proximal biliary duct. In 7 cases complicated with carcinoma of biliary duct, a polypoid soft tissue mass or nodule was seen inside the ductal lumen in 3 cases, or the duct wall was irregularly thickened in 4 patients. Six cases received curative operation, but one patient with extensive local infiltration, vascular encasement and lymphadenopathy had only palliative treatment. MR imaging observations were verified by surgery findings in all 13 patients.
Conclusion 　MR imaging is very valuable not only in diagnosing typeⅠ congenital choledochocele, but also in revealing its complications.

Citation： XIA Jindong,SONG Bin,ZHOU Xiangping. MRI Diagnosis and Preoperative Assessment of Type Ⅰ Congenital Choledochocele and Its Complications. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(3): 354-358. doi: Copy

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1. Todani T, Watanabe Y, Narusue M, et al. Congenital bile duct cysts: Classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst [J]. Am J Surg， 1977; 134(2)∶263.
2. 李正，王慧贞，吉士俊主编. 先天性畸形学 [M]. 北京：人民卫生出版社， 1999∶694~698.
3. Babbitt DP. Congenital choledochal cysts: new etiological concept based on anomalous relationships of the common bile duct and pancreatic bulb [J]. Ann Radiol, 1969; 12(3)∶231.
4. Komi N, Tamura T, Miyoshi Y, et al. Nationwide survey of cases of choledochal cyst. Analysis of coexistent anomalies, complications and surgical treatment in 645 cases [J]. Surg Gastroenterol， 1984; 3(2)∶69.
5. 李果珍主编. 临床CT诊断学 [M]. 北京: 中国科学技术出版社, 1996∶457~460.
6. 黄志强主编. 黄志强胆道外科学 [M]. 北京: 人民军医出版社, 1993∶158~164.
7. Chijiiwa K, Koga A. Surgical management and long-term follow-up of patients with choledochal cysts [J]. Am J Surg， 1993; 165(2)∶238.
8. Todani T, Watanabe Y, Toki A, et al. Carcinoma related to choledochal cysts with internal drainage operations [J]. Surg Gynecol Obstet， 1987; 164(1)∶61.
9. Reveille RM, Van Stiegmann G, Everson GT. Increased secondary bile acids in a choledochal cyst. Possible role in biliary metaplasia and carcinoma [J]. Gastroenterology， 1990; 99(2)∶525.
10. Han JK, Choi BI. Carcinoma in a choledochal cyst [J]. Abdom Imaging， 1996; 21(2)∶179.
11. 邬颖华，宋彬，徐隽，等. VIBE序列在原发性肝癌MRI诊断中的价值 [J]. 中国普外基础与临床杂志, 2005; 12(2)∶184.
12. 邬颖华，宋彬，徐隽，等. MRI VIBE 序列动态增强对肝脏局灶性病变的诊断价值 [J]. 中国普外基础与临床杂志, 2006; 13(2)∶227.
13. Yoshida H, Itai Y, Minami M, et al. Biliary malignancies occurring in choledochal cysts [J]. Radiology， 1989; 173(2)∶389.
14. Todani T, Tabuchi K, Watanabe Y, et al. Carcinoma arising in the wall of congenital bile duct cysts [J]. Cancer， 1979; 44(3)∶1134.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MRI Diagnosis and Preoperative Assessment of Type Ⅰ Congenital Choledochocele and Its Complications

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