CT and MRI findings of pediatric biliary rhabdomyosarcoma

SONG Qingbo; ZHENG Hui; LI Jinning; Gui Ting; ZHANG Yuzhen; WANG Dengbin

doi:10.20258/j.cnki.1006-9011.2025.11.019

Abstract：Objective The accurate imaging diagnosis of the biliary rhabdomyosarcoma(RMS)in the pediatric population can prove to be extremely challenging.The purpose of this article was to give an overview of computed tomography(CT)and mag-netic resonance imaging(MRI)findings with regard to pediatric biliary RMS and supplement it with a systematic review of the lit-eratures to improve its diagnostic accuracy.Methods In this retrospective study,we described the images of four pathologi-cally confirmed cases of pediatric biliary RMS.We performed a systematic review of the PubMed,Web of science,Zhiwang and Wanfang databases,using the search terms("biliary tree"OR"biliary tract"OR"bile duct"OR"choledochal")AND("rhab-domyosarcoma")and("bile"AND"rhabdomyosarcoma")from January 1,1980 to September 16,2023 to identify published cases of pediatric biliary RMS.We included them for analysis if CT or MRI informations were provided.Results We identified 32 articles of pediatric biliary RMS in the literatures and included only those 39 cases,along with the four index cases reported by us,we analysed the CT and MRI features of these 43 cases.The tumor occured in any part of intrahepatic and extrahepatic bile duct,and most of RMS were arised from the extrahepatic bile duct(n=25,58.1%).The tumor was low density on CT plain images.MRI typically demonstrated hypointense on T1-weighted imaging,hyperintense or slightly hyperintense on T2-weighted imageing and diffusion weighted imaging(DWI).The tumor showed varying degrees of enhancement.It tended to be distributed along the biliary system,and often accompanied by dilation of the intrahepatic bile ducts and(or)the common bile duct(CBD),which were characteristic manifestations of RMS.Conclusion There are some characteristic CT and MRI features of biliary RMS in children,which are useful to improve the diagnostic accuracy.