Preoperative evaluation of hilar cholangiocarcinoma with contrast-enhanced three-dimensional fast imaging with steady-state precession magnetic resonance angiography: comparison with intraarterial digital subtraction angiography.
We sought to evaluate the image quality of double-dose, contrast-enhanced 3D fast imaging with steady-state precession (FISP) magnetic resonance (MR) angiography in patients with hilar cholangiocarcinoma, and to compare its efficacy with intraarterial digital subtraction angiography (DSA). Thirty-six patients were studied to determine the visibility of the hepatic artery and portal vein with contrast-enhanced MR angiography. Determination of hepatic arterial and/or portal invasion from cholangiocarcinoma was compared between MR angiography and DSA as well. 0.2 mmol/kg gadolinium chelates were administrated at a rate of 4 ml/s. The hepatic artery was diagnostically visible in 28 patients (78%); the portal vein, in 34 patients (94%). The sensitivities, specificities, and accuracies in distinguishing arterial invasion, were 58%, 93%, and 89%, respectively, with MR angiography; 75%, 99%, and 96%, respectively, with DSA. In distinguishing portal venous invasion, these were 78%, 91%, and 89%, respectively, with MR angiography; 78%, 92%, and 90%, respectively, with DSA. There were no significant differences between imaging methods ( p >.05); however, DSA was superior in specificity regarding hepatic arterial invasion ( p =.0143). The data presented here indicate that noninvasive contrast-enhanced 3D FISP MR angiography has the potential to replace DSA in the preoperative evaluation of hilar cholangiocarcinoma.
Lee
Moon-Gyu
MG
Department of Radiology, University of Ulsan-Asan Medical Center, 388-1, Pungnap-dong, 138-736, Songpa-gu, Seoul, Korea. mglee@amc.seoul.kr
Park
Kwang Bo
KB
Shin
Yong Moon
YM
Yoon
Hyun Ki
HK
Sung
Kyu Bo
KB
Kim
Myung Hwan
MH
Lee
Sung Gyu
SG
Kang
Eun Mee
EM
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity