New Trends in Diffusion-Weighted Magnetic Resonance Imaging as a Tool in Differentiation of Serous Cystadenoma and Mucinous Cystic Tumor: A Prospective Study

New Trends in Diffusion-Weighted Magnetic Resonance Imaging as a Tool in Differentiation of Serous Cystadenoma and Mucinous Cystic Tumor: A Prospective Study

Author Schraibman, Vladimir Autor UNIFESP Google Scholar
Goldman, Suzan Menasce Autor UNIFESP Google Scholar
Ardengh, Jose Celso Google Scholar
Goldenberg, Alberto Autor UNIFESP Google Scholar
Lobo, Edson Autor UNIFESP Google Scholar
Linhares, Marcelo Moura Autor UNIFESP Google Scholar
Gonzales, Adriano Mizziara Autor UNIFESP Google Scholar
Abdala, Nitamar Autor UNIFESP Google Scholar
Abud, Thiago Giansante Autor UNIFESP Google Scholar
Ajzen, Sergio Aron Autor UNIFESP Google Scholar
Jackowsky, Andrea Google Scholar
Szejnfeld, Jacob Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Fundacao Inst Pesquisa & Estudo Diagnost Imagem
Abstract Background/Aims: Pancreatic cystic lesions are increasingly being recognized. Magnetic resonance imaging (MRI) is the method that brings the greatest amount of information about the morphologic features of pancreatic cystic lesions. To establish if diffusion-weighted MRI (DW-MRI) can be used as a tool to differentiate mucinous from nonmucinous lesions. Methods: Fifty-six patients with pancreatic cystic lesions (benign, n = 46; malignant, n = 10) were prospectively evaluated with DW-MRI in order to differentiate mucinous from nonmucinous lesions. Final diagnosis was obtained by follow-up (n = 31), surgery (n = 16) or endoscopic ultrasound-guided fine needle aspiration (n = 9). Serous cystadenoma was identified in 32 (57%) patients. Results: the threshold value established for the differentiation of mucinous from nonmucinous lesions was 2,230.06 s/mm(2) for ADC of 700. DWI-MRI behavior between mucinous and nonmucinous groups revealed sensitivity, specificity, positive predictive value, negative predictive value and accuracy to be 80, 98, 92, 93 and 93%, respectively (p<0.01, power of sample = 1.0). in the comparison of the diffusion behavior between mucinous (n = 13) and serous (n = 32) lesions, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 100, 97, 92, 100 and 98%, respectively (p<0.01, power of sample = 1.0). the results of endoscopic ultrasound-guided fine needle aspiration were similar to those of DW-MRI. Conclusions: DW-MRI can be included as part of the array of tools to differentiate mucinous from nonmucinous lesions and can help in the management of pancreatic cystic lesions. Copyright (C) 2011 S. Karger AG, Basel and IAP
Keywords Diffusion-weighted MRI
Pancreatic cysts
Abdomen
Neoplastic cysts
Endosonography
Fine needle aspiration biopsy
Language English
Date 2011-01-01
Published in Pancreatology. Basel: Karger, v. 11, n. 1, p. 43-51, 2011.
ISSN 1424-3903 (Sherpa/Romeo, impact factor)
Publisher Karger
Extent 43-51
Origin http://dx.doi.org/10.1159/000324565
Access rights Closed access
Type Article
Web of Science ID WOS:000298847500008
URI http://repositorio.unifesp.br/handle/11600/33332

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