Role of diffusion weighted imaging and dynamic contrast-enhanced MRI in assessing malignant and benign lesion in periamapullary regions / 实用放射学杂志

Objective To define the value of DCE and DWI in assessing malignant and benign lesion in periamapullary regions . Methods The data of dynamic contrast enhancement magnetic resonance imaging (DCE‐MRI) and diffusion‐weighted imaging(DWI) of 43 patients (32 malignant and 11 benign lesions) were analyzed retrospectively ,who have been diagnosed as biliary strictures in ampullary regions .One radiologist compared the signal intensity of DCE‐MRI and DWI of malignant and benign periamapullary le‐sions .Two other radiologists assessed data of DCE‐MRI and data of combined DCE‐MRI and DWI from those periamapullary lesions respectively .And then we compared the diagnostic sensitivity and specificity of each type of data by receiver operating characteristic (ROC) curve analysis .Results Malignant and benign periamapullary lesions showed no statistically significant difference on DCE‐MRI;Malignant periampullary lesion were more frequently appeared hyperintense than benign lesions on DWI ,and hypointense on ADC (P<0 .001) .Diagnostic accuracy improved from 84 .4% to 96 .9% and 87 .7% to 96 .6% for both reviewers after adding DWI on diagno‐sis of malignant periampuullary lesions .Conclusion The combination of DCE‐MRI and DWI can improve the diagnostic accuracy for differentiating malignant from benign strictures in the periampullary region .

The comparison of diagnostic value between endoscopic ultrasonography and computer tomography in periampullary lesions / 实用医学杂志

Objective To investigate the value of endoscopic ultrasonography (EUS) and abdominal CT (CT) in diagnosis of periampullary lesions and to make comparison between the two procedures. Methods The patients suspected of surrounding lesions of ampullary from 2009 to 2013 in our hospital were included in this study. All the patients received both EUS and abdominal CT. The accuracy rate of these two examination methods was compared. Results 151 patients were confirmed as surrounding lesions of ampullary, including choledocholithiasis, ampullary tumors, ampullary inflammation, tumors of the pancreatic head and pancreatic cysts. The accuracy rate of these diseases was 83.6%, 90.6%, 6.5%, 100.0%, and 100.0%for EUS;while was 52.2%, 56.3%, 43.5%, 91.3%, and 100.0%for abdominal CT. The tatal accuracy rate for diagnosing periampullary lesions by EUS was significantly higher than that by abdominal CT (84.1% vs. 59.6%). Conclusions Endoscopic ultrasonography has higher value in diagnosis of periampullary lesions, and its accurate rate was higher than that of abdominal CT.