Misdiagnosis Analysis of Intrahepatic Bile Duct Adenoma by Ultrasound and SonoVue Contrast-enhanced Ultrasound
WANG Hui
Abstract：Objective To explore the ultrasound images,and SonoVue contrast-enhanced ultrasound(CEUS)fea-tures of intrahepatic bile duct adenoma(BDA),as well as the causes of misdiagnosis and preventive measures.Methods Combined with relevant literature,the clinical and imaging data of 1 patient who had been misdiagnosed intrahepatic BDA in October 2022 were retrospectively analyzed.Results The patient presented with the left lobe nodule detected by ultrasound during physical examination 2 days before.There were no abnormalities in liver function and tumor markers.Upper abdominal magnetic resonance imaging(MRI),CT plain scan and enhanced scan showed abnormal manifestations of the left lobe of the liver,without excluding the possibility of small liver cancer.In ultrasound examination,a first class echo nodule was found near the capsule in the lower part of the left external lobe of the liver with a low echo halo,clear boundary and even internal echo,with a size of 1.2 cm×1.1 cm,slightly convex to the outside of the capsule.Due to unclear diagnosis,SonoVue CEUS was performed with the informed consent of the patient,and the intrahepatic nodule showed high enhancement at the ar-terial stage.The portal vein stage and the delayed stage showed equal enhancement.Based on ultrasound results,solid nod-ules with rich blood supply in the liver(except hepatocellular carcinoma)was considered.Laparoscopic hepatic nodule resec-tion and cholecystectomy were performed in clinical practice.Postoperative pathology showed epithelial tumors(left lobe of the liver)and cholangiocarcinoma(intrahepatic).The misdiagnosis lasted 10 d.The patients were well followed up for 2 years.Conclusion The clinical and laboratory examination of intrahepatic BDA is generally non-specific,and most of them are found by chance.The tumor is small in size,mostly under the liver capsule,and single,without capsule.The findings of CEUS are varied,and MRI,CT and ultrasound images are not specific.Radiologists should improve their understanding of the imaging features of intrahepatic BDA,pay attention to the combination of clinical symptoms and laboratory results,and con-duct a comprehensive evaluation of the lesions.
Keywords：Intrahepatic bile duct adenomaUltrasonographySonoVue contrast-enhanced ultrasoundMisdiagnosisHepatocellular carcinomaMagnetic resonance imagingTomographyspiral computed
Publication Date：2025-01-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 16-20 )