title: Lymphatic pathway around the pancreatic head and extrahepatic bile duct: evaluation using MR imaging at 3.0-T.
abstract: OBJECTIVE
  To evaluate the utility of spectral presaturation with inversion recovery (SPIR) T2-weighted images with 3-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) at 3.0-T for the detection of the normal lymphatic systems located around the pancreatic head and extrahepatic bile duct.
  
  
  METHODS
  Fifty-six patients with suspected hepatic or pancreaticobiliary diseases and diagnosed as normal or benign pathologies were evaluated as having normal lymphatic systems. The protocol consisted of SPIR T2-weighted sequences with 3D-VISTA. The lymphatic systems were defined as fluid signal intensity structures and divided into eight portions and interobserver agreement was evaluated using weighted kappa statistics. Three readers graded the visualization of each portion using a five-point scale. The detectability of each portion was calculated by defining grades 1-2 as detectable and grades 3-5 as undetectable.
  
  
  RESULTS
  Interobserver agreement regarding the visualization grades was moderate to almost perfect. All readers rated the detectability of the lymphatic systems of the superior and posterior portions of the pancreatic head, pericholedochal, right abdominoaortic, and interaorticovenous portions as 100%, and that of the anterior portion of the pancreatic head as 98.2%. For the inferior portion of the pancreatic head, the detectability was 100% for reader 2 and 96.4% for readers 1 and 3.
  
  
  CONCLUSIONS
  The lymphatic systems located around the pancreatic head and extrahepatic bile duct could be sufficiently visualized on SPIR T2-weighted images with 3D-VISTA at 3.0-T.
authors.affiliation: Department of Radiology, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan, yasunari@oita-u.ac.jp.
authors.forename: Yasunari
authors.initials: Y
authors.lastname: Yamada
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
authors.forename: Shunro
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Maki
authors.initials: M
authors.lastname: Kiyonaga
authors.forename: Michiaki
authors.initials: M
authors.lastname: Sai
authors.forename: Ryo
authors.initials: R
authors.lastname: Takaji
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Tomonari
authors.forename: Rika
authors.initials: R
authors.lastname: Tanoue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008208:Lymphatic System / Q000033:anatomy & histology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010179:Pancreas / Q000473:pathology*; D010183:Pancreatic Ducts / Q000473:pathology; D011446:Prospective Studies