title: Added value of diffusion-weighted imaging to MR cholangiopancreatography for the diagnosis of bile duct dilatations.
abstract: OBJECTIVE
  To investigate the added value of diffusion-weighted imaging (DWI) when used with conventional T2-weighted magnetic resonance (MR) imaging (T2WI) and MR cholangiopancreatography (MRCP) for diagnosing bile duct dilatations.
  
  
  METHODS
  Our institutional review board approved this retrospective study protocol and waived the informed consent requirement. The study included 151 consecutive patients (70 men, 81 women) with intra- and/or extra-hepatic bile duct dilatation examined using MR imaging. Two radiologists independently and randomly reviewed 3 image sets (A: MRCP and T2WI; B: DWI; and C: combined T2WI, MRCP, and DWI) at different occasions to differentiate between malignancy, biliary lithiasis, and benign dilatation. The sensitivity, specificity, and diagnostic accuracy of these imaging sets were calculated and compared.
  
  
  RESULTS
  For both readers, combined T2WI, MRCP, and DWI exhibited significantly higher sensitivity and diagnostic accuracy for malignant dilatation, compared with conventional T2WI and MRCP (P < 0.01 for both readers). However, DWI did not significantly affect the sensitivity and diagnostic accuracy for biliary lithiasis or benign dilatation.
  
  
  CONCLUSIONS
  The addition of DWI to T2WI and MRCP sequences yields significantly higher sensitivity and diagnostic accuracy when examining bile duct dilatations, particularly malignant dilatations.
authors.affiliation: Department of Medical Imaging, Kaohsiung Medical University Hospital, No. 100 Tz You 1st Road, Kaohsiung, 807, Taiwan.
authors.forename: Tzu-Hsueh
authors.initials: TH
authors.lastname: Tsai
authors.affiliation: Department of Medical Imaging, Kaohsiung Medical University Hospital, No. 100 Tz You 1st Road, Kaohsiung, 807, Taiwan.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Jui-Sheng
authors.initials: JS
authors.lastname: Hsu
authors.affiliation: Department of Medical Imaging, Kaohsiung Medical University Hospital, No. 100 Tz You 1st Road, Kaohsiung, 807, Taiwan.
authors.forename: Ming-Lai
authors.initials: ML
authors.lastname: Lai
authors.affiliation: Department of Medical Imaging, Kaohsiung Medical University Hospital, No. 100 Tz You 1st Road, Kaohsiung, 807, Taiwan.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Gin-Chung
authors.initials: GC
authors.lastname: Liu
authors.affiliation: Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Medical Imaging, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ming-Chen Paul
authors.initials: MC
authors.lastname: Shih
authors.affiliation: Department of Medical Imaging, Kaohsiung Medical University Hospital, No. 100 Tz You 1st Road, Kaohsiung, 807, Taiwan. ccy0103@hotmail.com.|Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. ccy0103@hotmail.com.|Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. ccy0103@hotmail.com.
authors.forename: Chiao-Yun
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging*; D001652:Bile Ducts / Q000000981:diagnostic imaging; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Bile duct dilatation; Diffusion-weighted imaging; Magnetic resonance cholangiopancreatography; T2-weighted magnetic resonance imaging