MRI features of intraductal papillary mucinous neoplasm of the bile ducts - "The myth about the cyst": A systematic review

Sep 24, 2026

Rationale and objectives: Intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is a true precancerous lesion sharing features with pancreatic IPMN (IPMN-P), yet remains poorly characterized. A systematic review evaluated existing literature, focusing on how MRI depicts IPMN-B. Materials and methods: PubMed identified original studies and case series reporting MR imaging features, using specified search terms; QUADAS-2 assessed risk of bias and applicability. Results: 884 records yielded 12 retrospective studies with MRI features from 288 patients, with classic features underreported and few worrisome findings. Conclusions: MRI features of IPMN-B need further study, and clearer reporting guidelines should be established.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Highlights

Entity of IPMN-B and its MRI recognition

Need for consensus on distinguishing signs

Early detection and prognosis

Article overview

Rationale and objectives

Materials and methods

Results

Conclusions

Introduction

Definition and imaging relevance of IPMN-B

European Journal of Radiology Open 11 (2023) 100515 Contents lists available at ScienceDirect European Journal of Radiology Open journal [homepage:](homepage: www.elsevier.com/locate/ejro)[ www.elsevier.com/locate/ejro](homepage: www.elsevier.com/locate/ejro) | Review
MRI features of intraductal papillary mucinous neoplasm of the bile ducts,“The myth about the cyst”: A systematic review
Matan Kraus a, b, *, Eyal Klanga, b, Shelly Soffer c, d, Yael Inbara, b, Eli Konena, b, Tamer Sobeha, b, Sara Aptera, b
a Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel b Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
c Internal Medicine B, Assuta Medical Center, Ashdod, Israel d Ben-Gurion University of the Negev, Be’er Sheva, Israel | | | | --- | --- | --- | | H I G H L I G H T S | | | | • The entity of IPMN-B, including its MRI features are poorly known.
• Distinguishing signs between IPMN-B and other hepatic or biliary cystic lesions or intraductal cholangiocarcinoma lack consensus.
• Radiologists should recognize IPMN-B, as early detection of its malignant transformation improves prognosis. | | | | A R T I C L E I N F O | | A B S T R A C T | | Keywords: Biliary tract IPMN IPNB
Cystic tumors Mucinous tumors | | Rationale and objectives: Intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is a true precancerous lesion, which shares common features with pancreatic IPMN (IPMN-P). While IPMN-P is a well described entity for which guidelines were formulated and revised, IPMN-B is a poorly described entity. We carried out a systematic review to evaluate the existing literature, emphasizing the role of MRI in IPMN-B depiction.
Materials and methods: PubMed database was used to identify original studies and case series that reported MR Imaging features of IPMN-B. The search keywords were "IPMN OR intraductal papillary mucinous neoplasm OR IPNB OR intraductal papillary neoplasm of the bile duct AND Biliary OR biliary cancer OR hepatic cystic lesions”. Risk of bias and applicability were evaluated using the QUADAS-2 tool.
Results: 884 Records were Identified through database searching. 12 studies satisfied the inclusion criteria, resulting in MR features of 288 patients. All the studies were retrospective. Classic features of IPMN-B are underdescribed. Few studies note worrisome features, concerning for an underlying malignancy. 50 % of the studies had a high risk of bias and concerns regarding applicability.
Conclusions: The MRI features of IPMN-B are not well elaborated and need to be further studied. Worrisome features and guidelines regarding reporting the imaging findings should be established and published. Radiologists should be aware of IPMN-B, since malignancy diagnosis in an early stage will yield improved prognosis | 1. Introduction Intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is a mucin producing cystic epithelial tumor. IPMN-B is characterized by intraluminal papillary ductal growth, communication with the biliary ducts, as well as intrahepatic and extrahepatic biliary ducts dilatation Abbreviations: IPMN-B, Intraductal papillary mucinous neoplasm of the bile ducts; IPMN-P, Intraductal papillary mucinous neoplasm of the pancreas; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses. * Correspondence to: Department of Diagnostic Imaging, Sheba Medical Center, 2 Sheba Road, Ramat Gan ZIP 5262000, Israel. E-mail addresses: [Matan.Kraus@gmail.com](Matan.Kraus@gmail.com), [Matan.Kraus@sheba.health.gov.il](Matan.Kraus@sheba.health.gov.il) (M. Kraus), [Eyal.Klang@sheba.health.gov.il](Eyal.Klang@sheba.health.gov.il) (E. Klang), [Shellyso@assuta.co.il](Shellyso@assuta.co.il) (S. Soffer), [Yael.Inbar@sheba.health.gov.il](Yael.Inbar@sheba.health.gov.il) (Y. Inbar), [Eli.Konen@sheba.health.gov.il](Eli.Konen@sheba.health.gov.il) (E. Konen), [Tamer.Sobeh@gmail.com](Tamer.Sobeh@gmail.com) (T

FAQs

What is the main purpose of this systematic review?

To evaluate existing literature on intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B), emphasizing the role of MRI in depicting IPMN-B.

How were studies identified and assessed in the review?

PubMed was used to find original studies and case series reporting MR imaging features of IPMN-B. QUADAS-2 was applied to evaluate risk of bias and applicability.

What do the review results suggest about reported MRI features of IPMN-B?

Classic MRI features are underdescribed, while worrisome features suggesting underlying malignancy are noted in only a few studies.

Why is recognizing IPMN-B important for clinical practice?

Early detection of malignant transformation improves prognosis, and radiologists should be aware of IPMN-B when interpreting imaging.

Sep 24, 2026

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