Comparative Study Of Applicable Value Of MR DWI And 3D-VIBE On Malignant Biliary Obstru-ction Diseases

Objective:To contrast magnetic resonance diffusion-weighted imaging (DWI) and three-dimentional volumetric interpolated breath-hold examination (3D-VIBE) in diagnosis and differential diagnosis on malignant biliary obstruction diseases.Method:All clinically suspected patients with biliary obstruction caused by malignant tumors were continuously screened, and 31 patients of that met the inclusion criteria accepted conventional abdominal MR scan sequences, MRCP scan, DWI and 3D-VIBE sequence scan. Apparent diffusion coefficient values (ADC value) were simultaneously measured on those eligible patients accepted DWI examination. All clinically eligible patients were classified into two groups:DWI group (conventional MR sequences+MRCP+DWI) and 3D-VIBE group (MR conventional sequences+MRCP+3D-VIBE), and the images and diagnostic results of both group were recorded to compare and analysis stastical difference with the "gold standard" of the surgical and pathological results finally.Results:31 cases were as folllows:cholangiocarcinomas were 17 cases, pancreatic cancers were 11 cases, ampullary carcinomas were 3 cases. The totally diagnostic coincidence rate of DWI group and 3D-VIBE group was 93.5% and 90.3% respectively, and chi-square testing of both group showed no statistical significance (P>0.05). The sensitivity of DWI in cholangiocarcinomas, pancreatic cancers, and ampullary carcinomas was 94.1%,100% and 66.7% respectively, that of 3D-VIBE was 88.2%,100% and 66.7% respectively. The average ADC values were as folllows: cholangiocarcinoma was ([1.083±0.166]×10-3mm2/s), pancreatic cancer was ([1.291±0.116]×10-3mm2/s), ampullary carcinoma was ([1.127±0.081]×10-3mm2/s), and the hypothesis testing between the ADC value of cholangiocarcinoma and pancreatic cancer showed statistical differences(P<0.05).Conclusion:The diagnosis and differential diagnosis between DWI and 3D-VIBE on malignant biliary obstruction diseases showed no statistical difference. Measuring ADC value contributed to distinguish cholangiocarcinoma and pancreatic cancer. So as a simple and easy examination method, DWI could be used as one of the preferred scan sequences.