Intraductal papillary neoplasm of the bile ducts: description of MRI and added value of diffusion-weighted MRI.

Abstract

PURPOSE:

To evaluate MRI features of intraductal papillary neoplasm of the bile duct (IPNB) and to determine added value of diffusion-weighted MRI (DWI).

METHODS:

Twenty-three patients with surgically confirmed invasive (n = 12) and non-invasive (n = 11) IPNB, who underwent preoperative liver MRI were included. Two observers performed consensus review of gadoxetic acid-enhanced MRI and combined gadoxetic acid-enhanced MRI including DWI separately, with regard to conspicuity of intraductal tumor using five point scales, extent of tumors, and the presence of invasiveness.

RESULTS:

On MRI, there was no significant difference in the conspicuity of intraductal tumors between gadoxetic acid MRI (mean, 4.35) and combined MRI (mean, 4.65) (P = 0.09). However, addition of DWI led seven cases revealed excellent conspicuity as compared with good or moderate conspicuity on gadoxetic acid MRI. With regard to invasiveness, 11 cases (48 %) and 17 (74 %) were correctly diagnosed with gadoxetic acid MRI and combined MRI, respectively (P = 0.06). In invasive tumors, both of the two image sets did not help assess accurate extent of the tumor.

CONCLUSIONS:

The addition of DWI to gadoxetic acid-enhanced MRI has a potency to improve conspicuity for intraductal tumors of IPNB and is helpful in determining tumor invasiveness, but not tumor extent.

• Authors: Hyun Jung Yoon, Young Kon Kim, Kee-Taek Jang, Kyu Taek Lee, Jong Kyun Lee, Dong Wook Choi, Jae Hoon Lim
• Journal: Abdominal imaging (Abdom Imaging) Vol. 38 Issue 5 Pg. 1082-90 (Oct 2013) ISSN: 1432-0509 [Electronic] United States
• PMID: 23508835 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Adult
• Aged
• Aged, 80 and over
• Bile Duct Neoplasms (pathology, surgery)
• Bile Ducts, Intrahepatic
• Carcinoma, Papillary (pathology, surgery)
• Cholangiocarcinoma (pathology, surgery)
• Contrast Media
• Diffusion Magnetic Resonance Imaging
• Female
• Gadolinium DTPA
• Humans
• Image Enhancement (methods)
• Image Interpretation, Computer-Assisted (methods)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Neoplasm Invasiveness