Open AccessThe added value of diffusion-weighted MR imaging to MR cholangiopancreatography in differentiating malignant from benign extrahepatic biliary strictures
Author(s) -
Rania Ali Maarouf,
Dalia Z. Zidan,
Maha A. El-Shinnawy
Publication year - 2013
Publication title -
the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 13
eISSN - 2090-4762
pISSN - 0378-603X
DOI - 10.1016/j.ejrnm.2013.09.005
Subject(s) - medicine , magnetic resonance cholangiopancreatography , radiology , magnetic resonance imaging , predictive value , diffusion mri , effective diffusion coefficient , endoscopic retrograde cholangiopancreatography , diffusion weighted magnetic resonance imaging , gastroenterology , pancreatitis
PurposeTo investigate the added value of diffusion-weighted imaging (DWI) to magnetic resonance cholangiopancreatography (MRCP) in differentiating benign from malignant extrahepatic biliary strictures.MethodsMagnetic resonance examination including, T2-weighted imaging, MRCP and DWI using different b-values (0,500,800s/mm2) were performed in 38 patients with suspicious extrahepatic biliary strictures. Apparent diffusion coefficient (ADC) value was calculated. The signal intensity of the lesions on DWI using b=500 and 800s/mm2 was examined. Analysis of the DWI and MRCP images for the cause of the extrahepatic biliary stricutre was performed. Patients were further confirmed by histopathological diagnosis and follow up. Sensitivity, specificity, accuracy, positive predictive and negative predictive values were calculated for both the MRCP images and DWI.ResultsOf the 38 cases, 23 cases had malignant extrahepatic biliary strictures and 15 had benign strictures. DWI detected 21 out of the 23 malignant biliary strictures and 14 out of 15 benign biliary strictures. Malignant strictures more frequently appeared hyperintense than benign strictures on DWI using b-values of 500 and 800s/mm2. There was a significant difference in sensitivity (91.3% vs. 73%), specificity (93.3% vs. 64.7%), accuracy (92.1% vs. 73.6%), positive predictive value (95.4% vs. 81%), and negative predictive value (87.5% vs. 64.7%) between DWI and MRCP in differentiating biliary strictures.ConclusionCombined evaluation using DWI added to MRCP improves the differentiation of malignant from benign extrahepatic biliary strictures