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- Title
Differential diagnosis of benign and malignant distal biliary strictures: Value of adding diffusion-weighted imaging to conventional magnetic resonance cholangiopancreatography.
- Authors
Yoo, Roh‐Eul; Lee, Jeong Min; Yoon, Jeong Hee; Kim, Jung Hoon; Han, Joon Koo; Choi, Byung Ihn
- Abstract
Purpose To determine the value of adding diffusion-weighted imaging (DWI) to conventional magnetic resonance cholangiopancreatography (MRCP) for differentiating benign from malignant distal biliary strictures. Materials and Methods Two independent readers reviewed three image sets (1: MRCP alone; 2: MRCP and DWI combined; and 3: MRCP, DWI, and contrast-enhanced T1-weighted imaging [T1WI] combined) of 60 patients with suspected distal biliary strictures and rated the probability of malignancy. Diagnostic performance and accuracy were compared using the receiver operating characteristic (ROC) curves and McNemar two-tailed test. κ coefficients were calculated to assess the interobserver agreement. Results The Az value and accuracy improved significantly after additional review of DWI for both readers: Az = 0.780 vs. 0.916 ( P = 0.003) for Reader 1 and 0.784 vs. 0.853 ( P = 0.037) for Reader 2; accuracy = 69% vs. 93% for Reader 1 ( P < 0.001) and 57% vs. 85% for Reader 2 ( P = 0.002). No significant difference in the Az values and accuracy was found between MRCP and DWI combined, and MRCP, DWI, and contrast-enhanced T1WI combined ( P > 0.050). There was substantial interobserver agreement in all three image sets (κ = 0.695-0.732). Conclusion The addition of DWI to MRCP significantly improved diagnostic accuracy in the characterization of distal biliary strictures. J. Magn. Reson. Imaging 2014;39:1509-1517. © 2013 Wiley Periodicals, Inc.
- Publication
Journal of Magnetic Resonance Imaging, 2014, Vol 39, Issue 6, p1509
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.24304