Aims and objectives
Differentiation of ductal adenocarcinoma from mass-forming pancreatitis is a continuing challenge for the radiologist.
this differential diagnosis is considerably difficult particularly with a single imaging modality.
Diffusion-weighted (DW) MRI is becoming increasingly important in the assessment of malignant tumors providing information about the biophysical properties of tissues.
Several studies have reported that ADC can contribute to the differential diagnosis of benign and malignant focal lesions.
contrast-enhanced Perfusion (CE-PW) MRI can improve the sensitivity and specificity of diagnostic imaging,
providing information concerning the...
Methods and materials
Thirty-five patients with pathologically confirmed solid pancreatic lesions (ductal adenocarcinoma,
n=18; endocrine tumour,
n=10; focal chronic pancreatitis,
n=7) underwent MR imaging at 3T-device (GE DISCOVERY MR750;GE Healthcare).
After T1 and T2-weighted sequences and MRCP,
imaging protocol included DW MRI using an axial respiratory-triggered spin-echo echo-planar sequence with multiple b-values (150,500,1000,1500 sec/mm²).
Multi-phasic CE-PW MRI consisted of a 3D T1w DISCO (differential subsampling with cartesian ordering) sequence repeated up to 5 minutes.
A dose of 0.1mL/Kg of Gadobutrolo (Gadovist,
Bayer HealthCare) with a 20mL saline flush...
Fitted ADC values were significantly lower in ductal adenocarcinomas than in the other lesions (p<0.05).
an overlapping of ADC measures was observed in the different solid pancreatic lesions.
All perfusion parameters were significantly different for each type of lesion (p<0.0001); Ve was the most helpful perfusion parameter in the differentiation of all types of pathologies (p=0.0005).The combination of ADC values and perfusion parameters improved the diagnostic accuracy (area under the curve = 0.903).
quantitative analysis of DW combined with CE-PW MRI at 3T-device may be helpful in the differential diagnosis of solid pancreatic lesions.
Boggi Ugo: email@example.com
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Various diffusion magnetic...