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Differentiation between pancreatic carcinoma and mass‐forming chronic pancreatitis: Usefulness of high b value diffusion‐weighted imaging
Author(s) -
HUANG Wen Cai,
SHENG Jing,
CHEN Shi Yue,
LU Jian Ping
Publication year - 2011
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1751-2980.2011.00517.x
Subject(s) - medicine , pancreatitis , pancreas , pancreatic carcinoma , effective diffusion coefficient , diffusion mri , gastroenterology , pancreatic mass , pancreatic cancer , carcinoma , pancreatitis, chronic , radiology , pathology , nuclear medicine , magnetic resonance imaging , cancer
OBJECTIVE: To investigate the value of high b value diffusion‐weighted (DW) imaging in differentiating between pancreatic carcinoma and mass‐forming chronic pancreatitis (MFCP). METHODS: Fifty‐one consecutive patients with pathology‐proven pancreatic carcinoma ( n = 37) or MFCP ( n = 14) were evaluated with DW imaging ( b value, 0 and 1000 s/mm 2 ) at a 3‐T MR system. Overall 20 healthy volunteers were evaluated as the control group. The apparent diffusion coefficient (ADC) values of normal pancreas, pancreatic carcinoma, MFCP, and mass‐associated obstructive pancreatitis were measured. RESULTS: On high b value (1000 s/mm 2 ) DW images, both pancreatic carcinoma and MFCP were hyperintense focal lesions; mass‐associated obstructive pancreatitis occurred in 17 of 37 (45.9%) pancreatic carcinoma and 8 of 14 (57.1%) MFCP. The ADC (×10 −3 mm 2 /s) of the pancreatic carcinomas (1.06 ± 0.15) was significantly lower than that of normal pancreas (1.47 ± 0.18; P < 0.01), MFCP (1.35 ± 0.14; P < 0.01) and mass‐associated chronic pancreatitis (1.44 ± 0.17; P < 0.01). The ADC of MFCP was also lower than that in the normal pancreas ( P = 0.025), whereas the ADC of mass‐associated obstructive pancreatitis was not different from those of the MFCP ( P = 0.113) and normal pancreas ( P = 0.544). When 1.195 was used as the optimal cut‐off value, ADC quantification obtained a sensitivity of 85.7% and a specificity of 86.5% for differentiating pancreatic carcinomas from MFCP. CONCLUSION: High b value DW imaging in combination with ADC quantification at a 3‐T MR system is useful in differentiating between pancreatic carcinoma and MFCP.