title: Differentiation grade for extrahepatic bile duct adenocarcinoma: Assessed by diffusion-weighted imaging at 3.0-T MR.
abstract: To assess the pathological differentiation grade in the patients with extrahepatic bile duct adenocarcinoma (EBDA) using diffusion-weighted imaging (DWI) at 3.0-T MR.
  Sixty-eight patients who were clinically and histologically diagnosed with EBDA underwent abdominal DWI within 2 weeks before surgery. The lesion signal intensity, signal intensity ratio of the lesion and hepar (SIR-LH) value, and apparent diffusion coefficient (ADC) value in patients with EBDA were retrospectively analysed.
  
  
  RESULTS
  -In the 68 patients, 22 well-differentiated, 36 moderately-differentiated, and 10 poorly-differentiated EBDAs were histopathological confirmed. These EBDAs exhibited hyper-intensity on DWI in 95.59% of patients. Hyper-intensity lesions were found in 90.91% of patients with good-differentiation, in 97.22% with moderate-differentiation and in 100% with poor-differentiation. There showed no statistical difference for the lesion signal intensity (P=0.426) and SIR-LH value (P=0.766) on DWI among three groups. The median ADC value of the well-differentiated, moderately-differentiated and poorly-differentiated EBDAs were 1.506×10-3mm2/s, 1.275×10-3mm2/s and 1.154×10-3mm2/s, respectively. As the pathological differentiation grade decreased, the lesion ADC value of EBDA gradually declined (x2=51.220, P=0.000). The ADC value <1.184×10-3mm2/s can predict the poorly-differentiated EBDA with a sensitivity of 100% and a specificity of 94.83%. The ADC value >1.316×10-3mm2/s can forecast the well-differentiated EBDA with a sensitivity of 100% and a specificity of 84.78%.
  The histopathological differentiation grade of EBDA can be detected non-invasively using DWI at 3.0-T MR.
authors: Department of Radiology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, PR China. Electronic address: 1109489147@qq.com.
authors: Xin-Qiao
authors: XQ
authors: Huang
authors: Department of Radiology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, PR China. Electronic address: shujiannc@163.com.
authors: Jian
authors: J
authors: Shu
authors: Department of Radiology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, PR China. Electronic address: 23857275@qq.com.
authors: Li
authors: L
authors: Luo
authors: Department of Radiology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, PR China. Electronic address: 1242037853@qq.com.
authors: Ming-Li
authors: ML
authors: Jin
authors: Department of Radiology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, PR China. Electronic address: 82901782@qq.com.
authors: Xiao-Fei
authors: XF
authors: Lu
authors: Department of Radiology, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, PR China. Electronic address: 82587849@qq.com.
authors: Shu-Gen
authors: SG
authors: Yang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Apparent diffusion coefficient value; Diffusion-weighted imaging; Extrahepatic bile duct adenocarcinoma; Magnetic resonance imaging; Pathological differentiation grade