Peribiliary Cyst





KEY FACTS


Terminology





  • Cystic dilatation of obstructed periductal glands of bile ducts



  • Retention cyst of peribiliary gland



Imaging





  • Well-defined, cystic structures adjacent to portal triads



  • Usually multiple; discrete, round/oval/tubular, or confluent configuration



  • Variable size, from 2 mm to 2 cm



  • Smooth and thin walls without internal echoes



  • No enhancement of contents on CECT or MR



  • Nonopacification with direct cholangiography or hepatobiliary-phase MR using hepatocyte-specific contrast agent




    • Do not communicate with biliary tree




Top Differential Diagnoses





  • Biliary ductal dilatation



  • Caroli disease



  • Hepatic autosomal dominant polycystic disease



  • Periportal edema/inflammation



Pathology





  • Disturbed portal venous flow, periductal fibrosis, and inflammation → obliteration of neck of peribiliary glands → formation of retention cyst



  • Associated with chronic hepatitis, cirrhosis, portal hypertension, portal vein thrombosis, liver transplantation



Clinical Issues





  • Peribiliary cysts are typically asymptomatic; symptoms often related to underlying liver disease



  • Obstructive jaundice may occur in end-stage liver cirrhosis or as complication of postliver transplantation



  • May increase in size and number of cysts as cirrhosis progresses



Scanning Tips





  • Do not confuse peribiliary cysts for biliary ductal dilatation







Grayscale ultrasound shows numerous small peribiliary cysts clustered in a linear configuration located along the portal vein .

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Nov 10, 2024 | Posted by in ULTRASONOGRAPHY | Comments Off on Peribiliary Cyst

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