评估增强CT和超声检查（US）发现胆囊内乳头状肿瘤（ICPN）并确定与浸润性癌（ICPN-IC）相关的ICPN成像特征。在这项回顾性研究中，我们招募了119名连续患者，其中60名男性和59名女性，平均年龄±标准差为63.3±12.1岁，经病理学确认为ICPN（低级别畸形[DP] = 34，高级别DP = 35，IC = 50）并接受了术前CT或US。两名放射科医师独立评估了CT和US的结果，重点是壁和息肉状病变的特征。将ICPN-IC的可能性分为5级评分。进行单变量和多变量 logistic 回归分析，分别识别壁和息肉状病变结果中的显著预测因素。评估CT和US在区分ICPN-IC和具有DP的ICPN（ICPN-DP）方面的性能，使用ROC曲线下面积（AUC）进行评估。 对于壁的特征而言，CT上的最大壁厚度（调整后的OR=1.4; 95%可信区间[CI]: 1.1-1.9）和粘膜不连续性（调整后的OR=5.6; 95% CI: 1.3-23.4）与ICPN-IC独立相关。在119个ICPN中，有110个（92.4%）显示出息肉状病变。关于息肉状病变结果，CT上的多发性（aOR=4.0; 95% CI: 1.6-10.4），病变基底壁增厚（aOR=6.0; 95% CI: 2.3-15.8），以及US上的息肉大小（aOR=1.1; 95% CI: 1.0-1.2）与ICPN-IC独立相关。CT在预测ICPN-IC方面的诊断性能优于US（AUC=0.793 vs. 0.676; p=0.002）。 ICPN在CT或US上显示出息肉状病变和/或壁增厚。厚壁、多发性、病变基底壁增厚和大息肉大小是成像发现与浸润性癌独立相关的，可能有助于区分ICPN-IC和ICPN-DP。版权所有 ©2023年韩国放射学会。

To assess the contrast-enhanced CT and ultrasonography (US) findings of intracholecystic papillary neoplasm (ICPN) and determine the imaging features predicting ICPN associated with invasive carcinoma (ICPN-IC).In this retrospective study, we enrolled 119 consecutive patients, including 60 male and 59 female, with a mean age ± standard deviation of 63.3 ± 12.1 years, who had pathologically confirmed ICPN (low-grade dysplasia [DP] = 34, high-grade DP = 35, IC = 50) and underwent preoperative CT or US. Two radiologists independently assessed the CT and US findings, focusing on wall and polypoid lesion characteristics. The likelihood of ICPN-IC was graded on a 5-point scale. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of ICPN-IC separately for wall and polypoid lesion findings. The performances of CT and US in distinguishing ICPN-IC from ICPN with DP (ICPN-DP) was evaluated using the area under the receiver operating characteristic curve (AUC).For wall characteristics, the maximum wall thickness (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.1-1.9) and mucosal discontinuity (aOR = 5.6; 95% CI: 1.3-23.4) on CT were independently associated with ICPN-IC. Among 119 ICPNs, 110 (92.4%) showed polypoid lesions. Regarding polypoid lesion findings, multiplicity (aOR = 4.0; 95% CI: 1.6-10.4), lesion base wall thickening (aOR = 6.0; 95% CI: 2.3-15.8) on CT, and polyp size (aOR = 1.1; 95% CI: 1.0-1.2) on US were independently associated with ICPN-IC. CT showed a higher diagnostic performance than US in predicting ICPN-IC (AUC = 0.793 vs. 0.676; p = 0.002).ICPN showed polypoid lesions and/or wall thickening on CT or US. A thick wall, multiplicity, presence of wall thickening in the polypoid lesion base, and large polyp size are imaging findings independently associated with invasive cancer and may be useful for differentiating ICPN-IC from ICPN-DP.Copyright © 2023 The Korean Society of Radiology.