title: Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms.
abstract: OBJECTIVE
  To investigate gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) of intraductal papillary mucinous neoplasms of the bile duct (IPMN-B).
  
  
  METHODS
  The imaging findings of five cases of IPMN-B which were pathologically confirmed at our hospital between March 2012 and May 2013 were retrospectively analyzed. Three of these cases were diagnosed by duodenal endoscopy and biopsy pathology, and two cases were diagnosed by surgical pathology. All five patients underwent enhanced and non-enhanced computed tomography (CT), magnetic resonance cholangiopancreatography, and Gd-EOB-DTPA-enhanced MRI; one case underwent both Gd-EOB-DTPA-enhanced MRI and positron emission tomography-CT. The clinical data and imaging results for these cases were compared and are presented.
  
  
  RESULTS
  Conventional imaging showed diffuse dilatation of bile ducts and multiple intraductal polypoid and papillary neoplasms or serrated changes along the bile ducts. In two cases, Gd-EOB-DTPA-enhanced MRI revealed dilated biliary ducts and intraductal tumors, as well as filling defects caused by mucin in the dilated bile ducts in the hepatobiliary phase. Gd-EOB-DTPA-enhanced MRI in one case clearly showed a low-signal tumor in the hepatobiliary phase, similar to what was seen by positron emission tomography-CT. In two patients, routine inspection was unable to discern whether the lesions were inflammation or tumors. However, Gd-EOB-DTPA-enhanced MRI revealed a pattern of gradual enhancement during the hepatobiliary phase, and the signal intensity of the lesions was lower than the surrounding liver parenchyma, suggesting tissue inflammation in both cases, which were confirmed by surgical pathology.
  
  
  CONCLUSIONS
  Gd-EOB-DTPA-enhanced MRI reveals the intraductal mucin component of IPMN-B in some cases and the extent of tumor infiltration beyond the bile ducts in invasive cases.
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Shi-Hong
authors.initials: SH
authors.lastname: Ying
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Teng
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Zhao-Ming
authors.initials: ZM
authors.lastname: Wang
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Qi-Dong
authors.initials: QD
authors.lastname: Wang
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Yi-Lei
authors.initials: YL
authors.lastname: Zhao
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.affiliation: Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
authors.forename: Wen-Bo
authors.initials: WB
authors.lastname: Xiao
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D049448:Cholangiopancreatography, Magnetic Resonance; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Bile duct neoplasms; Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid; Magnetic resonance cholangiopancreatography; Magnetic resonance imaging; Multidetector computed tomography