The role of diffusion-weighted MR imaging for differentiating benign from malignant bile duct strictures
- Authors
- Park, H.J.; Kim, S.H.; Jang, K.M.; Choi, S.-Y.; Lee, S.J.; Choi, D.
- Issue Date
- Apr-2014
- Publisher
- Springer Verlag
- Keywords
- Bile duct stricture; Cholangiocarcinoma; Diffusion-weighted imaging; Gadoxetic acid; Magnetic resonance imaging
- Citation
- European Radiology, v.24, no.4, pp 947 - 958
- Pages
- 12
- Journal Title
- European Radiology
- Volume
- 24
- Number
- 4
- Start Page
- 947
- End Page
- 958
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/13819
- DOI
- 10.1007/s00330-014-3097-x
- ISSN
- 0938-7994
1432-1084
- Abstract
- Objectives: To assess the added value of diffusion-weighted imaging (DWI) to conventional magnetic resonance imaging (MRI) for differentiating benign from malignant bile duct strictures. Methods: Twenty-seven patients with a benign stricture and 42 patients with a malignant stricture who had undergone gadoxetic acid-enhanced MRI with DWI were enrolled. Qualitative (signal intensity, dynamic enhancement pattern) and quantitative (wall thickness and length) analyses were performed. Two observers independently reviewed a set of conventional MRI and a combined set of conventional MRI and DWI, and receiver operating characteristic (ROC) curve analysis was assessed. Results: Benign strictures showed isointensity (18.5-70.4 %) and a similar enhancement pattern (22.2 %) to that of normal bile duct more frequently than malignant strictures (0-40.5 % and 0 %) on conventional MRI (P<0.05). Malignant strictures (90.5-92.9 %) showed hypervascularity on arterial and portal venous phase images more frequently than benign strictures (37.0-70.4 %) (P<0.01) On DWI, all malignant strictures showed hyperintensity compared with benign cases (70.4 %) (P<0.001). Malignant strictures were significantly thicker and longer than benign strictures (P<0.001). The diagnostic performance of both observers improved significantly after additional review of DWI. Conclusions: Adding DWI to conventional MRI is more helpful for differentiating benign from malignant bile duct strictures than conventional MRI alone. Key points: • Accurate diagnosis and exclusion of benign strictures of bile duct are important. • Diffusion-weighted MRI helps to distinguish benign from malignant bile duct strictures. • DWI plus conventional MRI provides superior diagnostic accuracy to conventional MRI alone. © 2014 European Society of Radiology.
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