Skip to main content
Top
Published in: Abdominal Radiology 3/2016

01-03-2016

Added value of diffusion-weighted imaging to MR cholangiopancreatography for the diagnosis of bile duct dilatations

Authors: Tzu-Hsueh Tsai, Jui-Sheng Hsu, Ming-Lai Lai, Gin-Chung Liu, Ming-Chen Paul Shih, Chiao-Yun Chen

Published in: Abdominal Radiology | Issue 3/2016

Login to get access

Abstract

Purpose

To investigate the added value of diffusion-weighted imaging (DWI) when used with conventional T2-weighted magnetic resonance (MR) imaging (T2WI) and MR cholangiopancreatography (MRCP) for diagnosing bile duct dilatations.

Methods

Our institutional review board approved this retrospective study protocol and waived the informed consent requirement. The study included 151 consecutive patients (70 men, 81 women) with intra- and/or extra-hepatic bile duct dilatation examined using MR imaging. Two radiologists independently and randomly reviewed 3 image sets (A: MRCP and T2WI; B: DWI; and C: combined T2WI, MRCP, and DWI) at different occasions to differentiate between malignancy, biliary lithiasis, and benign dilatation. The sensitivity, specificity, and diagnostic accuracy of these imaging sets were calculated and compared.

Results

For both readers, combined T2WI, MRCP, and DWI exhibited significantly higher sensitivity and diagnostic accuracy for malignant dilatation, compared with conventional T2WI and MRCP (P < 0.01 for both readers). However, DWI did not significantly affect the sensitivity and diagnostic accuracy for biliary lithiasis or benign dilatation.

Conclusion

The addition of DWI to T2WI and MRCP sequences yields significantly higher sensitivity and diagnostic accuracy when examining bile duct dilatations, particularly malignant dilatations.
Literature
1.
go back to reference Kim MJ, Mitchell DG, Ito K, Outwater EK (2000) Biliary dilatation: differentiation of benign from malignant causes—value of adding conventional MR imaging to MR cholangiopancreatography. Radiology 214:173–181CrossRefPubMed Kim MJ, Mitchell DG, Ito K, Outwater EK (2000) Biliary dilatation: differentiation of benign from malignant causes—value of adding conventional MR imaging to MR cholangiopancreatography. Radiology 214:173–181CrossRefPubMed
2.
go back to reference Soto JA, Alvarez O, Lopera JE, et al. (2000) Biliary obstruction: findings at MR cholangiography and cross-sectional MR imaging. Radiographics 20:353–366CrossRefPubMed Soto JA, Alvarez O, Lopera JE, et al. (2000) Biliary obstruction: findings at MR cholangiography and cross-sectional MR imaging. Radiographics 20:353–366CrossRefPubMed
3.
go back to reference Mittal PK, Moreno CC, Kalb B, et al. (2015) Primary biliary tract malignancies: MRI spectrum and mimics with histopathological correlation. Abdom Imaging 40:1520–1557CrossRefPubMed Mittal PK, Moreno CC, Kalb B, et al. (2015) Primary biliary tract malignancies: MRI spectrum and mimics with histopathological correlation. Abdom Imaging 40:1520–1557CrossRefPubMed
4.
go back to reference Kim JH, Kim MJ, Chung JJ, et al. (2002) Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics 22:1335–1352CrossRefPubMed Kim JH, Kim MJ, Chung JJ, et al. (2002) Differential diagnosis of periampullary carcinomas at MR imaging. Radiographics 22:1335–1352CrossRefPubMed
5.
go back to reference Lim JH, Kim MH, Kim TK, et al. (2003) Papillary neoplasms of the bile duct that mimic biliary stone disease. Radiographics 23:447–455CrossRefPubMed Lim JH, Kim MH, Kim TK, et al. (2003) Papillary neoplasms of the bile duct that mimic biliary stone disease. Radiographics 23:447–455CrossRefPubMed
6.
go back to reference Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed
7.
go back to reference Padhani AR, Liu G, Koh DM, et al. (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125CrossRefPubMedPubMedCentral Padhani AR, Liu G, Koh DM, et al. (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125CrossRefPubMedPubMedCentral
8.
go back to reference Qayyum A (2009) Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications. Radiographics 29:1797–1810CrossRefPubMed Qayyum A (2009) Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications. Radiographics 29:1797–1810CrossRefPubMed
9.
go back to reference Cui XY, Chen HW, Cai S, et al. (2012) Diffusion-weighted MR imaging for detection of extrahepatic cholangiocarcinoma. Eur J Radiol 81:2961–2965CrossRefPubMed Cui XY, Chen HW, Cai S, et al. (2012) Diffusion-weighted MR imaging for detection of extrahepatic cholangiocarcinoma. Eur J Radiol 81:2961–2965CrossRefPubMed
10.
go back to reference Chung YE, Kim MJ, Kim HM, et al. (2011) Differentiation of benign and malignant ampullary obstructions on MR imaging. Eur J Radiol 80:198–203CrossRefPubMed Chung YE, Kim MJ, Kim HM, et al. (2011) Differentiation of benign and malignant ampullary obstructions on MR imaging. Eur J Radiol 80:198–203CrossRefPubMed
11.
go back to reference Yoo RE, Lee JM, Yoon JH, et al. (2014) Differential diagnosis of benign and malignant distal biliary strictures: value of adding diffusion-weighted imaging to conventional magnetic resonance cholangiopancreatography. J Magn Reson Imaging 39:1509–1517CrossRefPubMed Yoo RE, Lee JM, Yoon JH, et al. (2014) Differential diagnosis of benign and malignant distal biliary strictures: value of adding diffusion-weighted imaging to conventional magnetic resonance cholangiopancreatography. J Magn Reson Imaging 39:1509–1517CrossRefPubMed
12.
go back to reference Park HJ, Kim SH, Jang KM, et al. (2014) The role of diffusion-weighted MR imaging for differentiating benign from malignant bile duct strictures. Eur Radiol 24:947–958CrossRefPubMed Park HJ, Kim SH, Jang KM, et al. (2014) The role of diffusion-weighted MR imaging for differentiating benign from malignant bile duct strictures. Eur Radiol 24:947–958CrossRefPubMed
13.
go back to reference Roth CG (2011) Fundamentals of body MRI, 1st edn. Philadelphia: Elsevier, pp 178–180 Roth CG (2011) Fundamentals of body MRI, 1st edn. Philadelphia: Elsevier, pp 178–180
14.
go back to reference Piana G, Trinquart L, Meskine N, et al. (2011) New MR imaging criteria with a diffusion-weighted sequence for the diagnosis of hepatocellular carcinoma in chronic liver diseases. J Hepatol 55:126–132CrossRefPubMed Piana G, Trinquart L, Meskine N, et al. (2011) New MR imaging criteria with a diffusion-weighted sequence for the diagnosis of hepatocellular carcinoma in chronic liver diseases. J Hepatol 55:126–132CrossRefPubMed
15.
go back to reference Sevcenco S, Heinz-Peer G, Ponhold L, et al. (2014) Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors. Eur J Radiol 83:909–913CrossRefPubMed Sevcenco S, Heinz-Peer G, Ponhold L, et al. (2014) Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors. Eur J Radiol 83:909–913CrossRefPubMed
16.
go back to reference Jang KM, Kim SH, Min JH, et al. (2014) Value of diffusion-weighted MRI for differentiating malignant from benign intraductal papillary mucinous neoplasms of the pancreas. AJR Am J Roentgenol 203:992–1000CrossRefPubMed Jang KM, Kim SH, Min JH, et al. (2014) Value of diffusion-weighted MRI for differentiating malignant from benign intraductal papillary mucinous neoplasms of the pancreas. AJR Am J Roentgenol 203:992–1000CrossRefPubMed
17.
go back to reference Hekimoglu K, Ustundag Y, Dusak A, et al. (2008) MRCP vs. ERCP in the evaluation of biliary pathologies: review of current literature. J Dig Dis 9:162–169CrossRefPubMed Hekimoglu K, Ustundag Y, Dusak A, et al. (2008) MRCP vs. ERCP in the evaluation of biliary pathologies: review of current literature. J Dig Dis 9:162–169CrossRefPubMed
18.
19.
go back to reference Naganawa S, Kawai H, Fukatsu H, et al. (2005) Diffusion-weighted imaging of the liver: technical challenges and prospects for the future. Magn Reson Med Sci 4:175–186CrossRefPubMed Naganawa S, Kawai H, Fukatsu H, et al. (2005) Diffusion-weighted imaging of the liver: technical challenges and prospects for the future. Magn Reson Med Sci 4:175–186CrossRefPubMed
20.
go back to reference Kandpal H, Sharma R, Madhusudhan KS, Kapoor KS (2009) Respiratory-triggered versus breath-hold diffusion-weighted MRI of liver lesions: comparison of image quality and apparent diffusion coefficient values. AJR Am J Roentgenol 192:915–922CrossRefPubMed Kandpal H, Sharma R, Madhusudhan KS, Kapoor KS (2009) Respiratory-triggered versus breath-hold diffusion-weighted MRI of liver lesions: comparison of image quality and apparent diffusion coefficient values. AJR Am J Roentgenol 192:915–922CrossRefPubMed
Metadata
Title
Added value of diffusion-weighted imaging to MR cholangiopancreatography for the diagnosis of bile duct dilatations
Authors
Tzu-Hsueh Tsai
Jui-Sheng Hsu
Ming-Lai Lai
Gin-Chung Liu
Ming-Chen Paul Shih
Chiao-Yun Chen
Publication date
01-03-2016
Publisher
Springer US
Published in
Abdominal Radiology / Issue 3/2016
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-015-0612-8

Other articles of this Issue 3/2016

Abdominal Radiology 3/2016 Go to the issue

Classics in Abdominal Imaging

The “winking owl” sign

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.