Imaging findings of biliary hamartomas (von Meyenburg complexes)

Springer Science and Business Media LLC - Tập 32 Số 4 - Trang 205-212 - 2005
Zheng, Rong Qin1, Kudo, Masatoshi1, Onda, Hirokazu1, Inoue, Tatsuo1, Maekawa, Kiyoshi2, Minami, Yasunori1, Chung, Hobyung1, Kitano, Masayuki1, Kawasaki, Toshihiko1
1Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka, Japan
2Abdominal Ultrasound Unit, Kinki University School of Medicine, Osaka, Japan

Tóm tắt

To evaluate the imaging findings of biliary hamartomas (von Meyenburg complexes, vMCs) and discuss their differential diagnosis from other related diseases, imaging findings of biliary hamartomas on ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary scintigraphy were prospectively analyzed in six patients. On ultrasound images, five of the six cases showed multiple small hyper- and hypoechoic lesions with comet-tail echoes, especially when magnified using the zoom function. In all six cases, multiple tiny hypodense lesions less than 10 mm in diameter were scattered throughout the liver with no enhancement on CT. These tiny lesions were demonstrated to be hyper- and hypointense on T2- and TI-weighted images, respectively, in three patients who underwent MRI examinations. MRCP was performed in two patients, and it clearly showed multiple tiny round and irregular-shaped hyperintense lesions. MRCP and hepatobiliary scintigraphy showed normal appearances of intra- and extrahepatic bile ducts in two and one patients, respectively. Imaging modalities are useful in the diagnosis and differential diagnosis of vMCs. A correct diagnosis might be obtained when typical imaging findings present even without histological confirmation.

Tài liệu tham khảo

citation_journal_title=AJR Am J Roentgenol; citation_title=The radiologic and pathologic spectrum of biliary hamartomas; citation_author=AS Lev-Toaff, AM Bach, RJ Wechsler; citation_volume=165; citation_publication_date=1995; citation_pages=309-13; citation_id=CR1 citation_journal_title=J Clin Gastroenterol; citation_title=Bile duct hamartomas: a report of two cases; citation_author=SC Wei, GT Huang, CH Chen; citation_volume=25; citation_publication_date=1997; citation_pages=608-11; citation_doi=10.1097/00004836-199712000-00012; citation_id=CR2 citation_journal_title=J Comput Assist Tomogr; citation_title=Von Meyenburg complexes of the liver: imaging findings; citation_author=TY Luo, Y Itai, N Eguchi; citation_volume=22; citation_publication_date=1998; citation_pages=372-8; citation_doi=10.1097/00004728-199805000-00006; citation_id=CR3 citation_journal_title=Clin Radiol; citation_title=The appearances of multiple biliary hamartomas of the liver (von Meyenburg complexes) on computed tomography; citation_author=JC Cook, DAP Cooke; citation_volume=38; citation_publication_date=1987; citation_pages=101-2; citation_id=CR4 citation_journal_title=J Comput Assist Tomogr; citation_title=Hepatic bile duct hamartoma (von Meyenburg complexes): MR and MR cholangiography findings; citation_author=B Mortele, K Mortele, P Seynaeve; citation_volume=26; citation_publication_date=2002; citation_pages=438-43; citation_doi=10.1097/00004728-200205000-00021; citation_id=CR5 citation_journal_title=Am J Gastroenterol; citation_title=Bile duct hamartomas presenting as multiple focal lesions on hepatic ultrasonography; citation_author=J Salo, C Bru, A Vilella; citation_volume=87; citation_publication_date=1992; citation_pages=221-3; citation_id=CR6 citation_journal_title=Acta Radiol; citation_title=Multiple bile duct hamartomas: US, CT, and MR findings. A case report; citation_author=JC Gallego, I Suarez, R Soler; citation_volume=36; citation_publication_date=1995; citation_pages=273-5; citation_doi=10.3109/02841859509177633; citation_id=CR7 citation_journal_title=Cancer; citation_title=Multiple bile-duct hamartomas; citation_author=EB Chung; citation_volume=26; citation_publication_date=1970; citation_pages=287-96; citation_id=CR8 citation_journal_title=Acta Pathol Microbiol Scand [A]; citation_title=Biliary hamartomas (von Meyenburg complexes) in liver needle biopsies; citation_author=N Thommesen; citation_volume=86; citation_publication_date=1978; citation_pages=93-9; citation_id=CR9 citation_journal_title=Mod Pathol; citation_title=The hepatic von Meyenburg complex: prevalence and association with hepatic and renal cysts among 2843 autopsies [corrected]; citation_author=MS Redston, IR Wanless; citation_volume=9; citation_publication_date=1996; citation_pages=233-7; citation_id=CR10 citation_journal_title=Virchows Arch; citation_title=Cholangiocarcinoma arising in bile duct adenoma with focal area of bile duct hamartoma; citation_author=T Hesebe, K Sakamoto M. Mukai; citation_volume=436; citation_publication_date=1995; citation_pages=209-13; citation_id=CR11 citation_journal_title=J Clin Gastroenterol; citation_title=Adenocarcinoid of the liver arising within an area of hamartoma with predominant bile duct component; citation_author=N Papadogiannakis, A Gad, S Sjostedt; citation_volume=23; citation_publication_date=1996; citation_pages=145-51; citation_doi=10.1097/00004836-199609000-00018; citation_id=CR12 citation_journal_title=AJR Am J Roentgenol; citation_title=CT and sonography of multiple bile-duct hamartomas simulating malignant liver disease; citation_author=D Eisenberg, L Hurwitz, AC Yu; citation_volume=147; citation_publication_date=1986; citation_pages=279-80; citation_id=CR13 citation_journal_title=Kurume Med J; citation_title=Biliary hamartomas simulating multiple hepatic metastasis on imaging findings; citation_author=H Iha, Y Nakashima, Y Fukukura; citation_volume=43; citation_publication_date=1996; citation_pages=231-5; citation_id=CR14 citation_journal_title=J Clin Ultrasound; citation_title=Sonogram of multiple bile duct hamartomas; citation_author=A Tan, JF Shen, AH Hecht; citation_volume=17; citation_publication_date=1989; citation_pages=667-9; citation_id=CR15 citation_journal_title=Australas Radiol; citation_title=Computed tomography of von Meyenburg complex simulating micro-abscesses; citation_author=P Sada, B Ramakrishna; citation_volume=38; citation_publication_date=1994; citation_pages=225-6; citation_id=CR16 citation_journal_title=Clin Radiol; citation_title=Case report: imaging of bile duct hamartomas; citation_author=C Martinoli, G Cittadini, GA Rollandi, R Gonzi; citation_volume=45; citation_publication_date=1992; citation_pages=203-5; citation_doi=10.1016/S0009-9260(05)80644-0; citation_id=CR17 citation_journal_title=AJR Am J Roentgenol; citation_title=MR findings of multiple biliary hamartomas; citation_author=HW Shone, WF Bennett, JG Bova; citation_volume=161; citation_publication_date=1993; citation_pages=581-3; citation_id=CR18 citation_journal_title=Abdom Imaging; citation_title=Bile duct hamartomas (von Meyenburg complexes): value of MR imaging in diagnosis; citation_author=MM Maher, P Dervan, B Keogh; citation_volume=24; citation_publication_date=1999; citation_pages=171-3; citation_doi=10.1007/s002619900469; citation_id=CR19 citation_journal_title=J Gastroenterol; citation_title=Hepatic peribiliary cysts: clinical harmless disease with potential risk due to gradual increase in size and number; citation_author=M Kudo; citation_volume=36; citation_publication_date=2001; citation_pages=286-8; citation_id=CR20 citation_journal_title=J Gastroenterol Hepatol; citation_title=Intrahepatic peribiliary glands of humans. II. Pathological spectrum; citation_author=Y Nakanuma, M Sasaki, T Terada; citation_volume=9; citation_publication_date=1994; citation_pages=80-6; citation_id=CR21 citation_journal_title=Radiology; citation_title=Ultrasonography and computed tomography in the evaluation of hepatic microabscesses in the immunosuppressed patient; citation_author=PW Callen, RA Filly, FS Marcus; citation_volume=136; citation_publication_date=1980; citation_pages=433-4; citation_id=CR22 citation_title=Basic ultrasound physics; citation_inbook_title=Ultrasound physics and instrumentation; citation_publication_date=1995; citation_pages=1-30; citation_id=CR23; citation_author=WR Hedrick; citation_author=DL Hykes; citation_author=DE Starchman; citation_publisher=Mosby citation_title=Image artifacts; citation_inbook_title=Ultrasound physics and instrumentation; citation_publication_date=1995; citation_pages=314-29; citation_id=CR24; citation_author=WR Hedrick; citation_author=DL Hykes; citation_author=DE Starchman; citation_publisher=Mosby citation_journal_title=J Clin Ultrasound; citation_title=Sonograms of multiple bile duct hamartomas; citation_author=A Tan, JF Shen, AH Hecht; citation_volume=17; citation_publication_date=1989; citation_pages=667-9; citation_id=CR25 citation_journal_title=J Clin Ultrasound; citation_title=Sonographic features of von Meyenburg complexes (VMCs); citation_author=M Niizawa, H Ishida, M Itoh; citation_volume=19; citation_publication_date=1991; citation_pages=288-93; citation_id=CR26 citation_journal_title=Am J Gastroenterol; citation_title=Bile duct hamartomas presenting as multiple focal lesions on hepatic ultrasonography; citation_author=J Salo, C Bru, A Vilella; citation_volume=87; citation_publication_date=1992; citation_pages=221-3; citation_id=CR27