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Updated: May 22, 2026
Isolation of Neonatal Extrahepatic Cholangiocytes
Published on: June 5, 2014
MRI features of fetal type I congenital choledochal cyst and parameter measurement of hepatobiliary development
Leilei Gu1, Duo Gao1, Yimin Cao1
1Department of Medical Imaging, The Second Hospital of Hebei Medical University, No. 215 Heping West Street, Shijiazhuang, Hebei Province, 050000, China.
Objectives:
To observe fetal MRI findings of type I congenital choledochal cyst (CCC) and the developmental differences in abdominal organs between fetuses with CCC and normal controls.
Methods:
This retrospective study included 90 normal fetuses and 31 fetuses with surgically confirmed CCC. MRI was used to observe CCC morphology, orientation, connection with bile duct or gallbladder, and its relationship with the liver edge. Cyst volume was calculated. Measurements, including the lung-to-liver signal intensity ratio (LLIR), liver (transverse and craniocaudal diameters, maximum cross-sectional area), spleen (long diameter, thickness, maximum cross-sectional area), gallbladder (long diameter, short diameter, maximum cross-sectional area), and portal vein diameter were compared between the two groups. Correlation between cyst volume and MRI parameters was analyzed.
Results:
Among the 31 CCC cases, 70.9% were female. The choledochal cyst morphology was elliptical in 26 cases. A "pointed apex sign" was observed in all cases. The inferior margin of the cyst did not extend beyond the inferior edge of the liver in 29 cases. The predominant orientation of the cyst was right upper to left lower in 26 cases. Compared to controls, CCC fetuses showed significantly larger splenic cross-sectional area, increased portal vein diameter, and higher gallbladder long-to-short diameter ratio (all P < 0.05).
Conclusion:
CCC predominantly occurs in females. Fetal MRI findings typically show an elliptical lesion, generally not extending beyond the inferior edge of the liver, with a right upper to left lower orientation and a "pointed apex sign" at its superior margin. Affected fetuses exhibit an enlarged spleen, a widened portal vein, and an increased ratio of the gallbladder's long-to-short diameter. However, the cyst volume shows no correlation with these changes.
Insights
Fetal MRI reveals type I congenital choledochal cysts (CCC) often present as elliptical lesions with a "pointed apex sign." Affected fetuses show spleen enlargement and portal vein widening, but cyst volume doesn't correlate with these changes.
Area of Science:
- Fetal imaging and pediatric surgery
- Gastrointestinal and hepatobiliary development
Background:
- Congenital choledochal cysts (CCC) are rare biliary malformations.
- Accurate prenatal diagnosis is crucial for timely intervention and management.
Purpose of the Study:
- To characterize fetal MRI findings of type I CCC.
- To identify developmental differences in abdominal organs in fetuses with CCC compared to controls.
Main Methods:
- Retrospective analysis of fetal MRI scans from 31 CCC cases and 90 controls.
- Detailed assessment of CCC morphology, orientation, and relationship with surrounding structures.
- Quantitative comparison of organ measurements including spleen, gallbladder, and portal vein diameters.
Main Results:
- Type I CCC predominantly affects females, appearing as elliptical lesions with a "pointed apex sign".
- CCC fetuses exhibited significantly larger spleen size, wider portal veins, and increased gallbladder long-to-short diameter ratio compared to controls.
- No significant correlation was found between CCC volume and observed developmental changes.
Conclusions:
- Fetal MRI provides characteristic features for diagnosing type I CCC.
- Prenatal identification of associated organ changes like splenomegaly and portal vein dilation is important.
- These findings aid in understanding the spectrum of fetal anomalies associated with CCC.