title: Intraductal papillary neoplasm of the bile ducts: description of MRI and added value of diffusion-weighted MRI.
abstract: OBJECTIVE
  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.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Young Kon
authors.initials: YK
authors.lastname: Kim
authors.forename: Kee-Taek
authors.initials: KT
authors.lastname: Jang
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA