Advertisement

Diffusion-Weighted MR Imaging of the Pancreas

  • Jorge A. SotoEmail author
  • German A. Castrillon
  • Stephan Anderson
  • Nagaraj Holalkere
Chapter

Abstract

Publications exploring the use of DWI for evaluation of pancreatic disease are limited in number and scope. However, the value of DWI in various pancreatic conditions continues to be explored and available results suggest that there will likely be a niche for this technique in the clinic. Available studies have shown that the measured ADC values of the normal pancreatic glandular parenchyma on DWI vary considerably and are determined by factors such as age, the anatomic portion of the gland, and magnet field strength. Normal pancreas has significantly higher mean ADC than pancreatic cancer or mass-forming pancreatitis. Furthermore, proper use of DWI may aid in the differentiation of focal pancreatitis from ductal adenocarcinoma. Besides, in patients with known pancreatic cancer, the benefits of DWI include improved characterization of enlarged lymph nodes, detection of peritoneal carcinomatosis, and detection of distant (such as hepatic) metastases. It is also possible that ADC measurements can be used as a quantitative tool for predicting and monitoring tumor response. There is some data that supports the use of DWI for characterizing and determining the significance of pancreatic cystic lesions. There is still very little published scientific data to support the use of DWI in the gallbladder and biliary tract, although cholangiocarcinoma exhibits diffusion restriction, which is helpful for separating the lesion from the surrounding hepatic parenchyma, and neoplastic and inflammatory diseases of the gallbladder can also be evaluated with MR.

Keywords

Chronic Pancreatitis Primary Sclerosing Cholangitis Acute Cholecystitis Main Pancreatic Duct Hydatid Cyst 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Further Reading

  1. Balci NC, Perman WH, Saglam S et al (2009) Diffusion-weighted magnetic resonance imaging of the pancreas. Top Magn Reson Imaging 20(1):43–47PubMedCrossRefGoogle Scholar
  2. Cui XY, Chen HW (2010) Role of diffusion-weighted magnetic resonance imaging in the diagnosis of extrahepatic cholangiocarcinoma. World J Gastroenterol 16(25):3196–3201PubMedCrossRefGoogle Scholar
  3. Dale BM, Braithwaite AC, Boll DT et al (2010) Field strength and diffusion encoding technique affect the apparent diffusion coefficient measurements in diffusion-weighted imaging of the abdomen. Invest Radiol 45(2):104–108PubMedCrossRefGoogle Scholar
  4. Fattahi R, Balci NC, Perman WH et al (2009) Pancreatic diffusion-weighted imaging (DWI): comparison between mass-forming focal pancreatitis (FP), pancreatic cancer (PC), and normal pancreas. J Magn Reson Imaging 29(2):350–356PubMedCrossRefGoogle Scholar
  5. Grünberg K, Grenacher L, Klauß M (2011) Diffusion-weighted imaging of the pancreas. Radiologe 51(3):186–194PubMedCrossRefGoogle Scholar
  6. Inan N, Arslan A, Akansel G et al (2008) Diffusion-weighted imaging in the differential diagnosis of cystic lesions of the pancreas. Am J Roentgenol 191(4):1115–1121CrossRefGoogle Scholar
  7. Irie H, Honda H, Kuroiwa T et al (2002) Measurement of the apparent diffusion coefficient in intraductal mucin-producing tumor of the pancreas by diffusion-weighted echo-planar MR imaging. Abdom Imaging 27(1):82–87PubMedCrossRefGoogle Scholar
  8. Kamisawa T, Takuma K, Anjiki H et al (2010) Differentiation of autoimmune pancreatitis from pancreatic cancer by diffusion-weighted MRI. Am J Gastroenterol 105(8):1870–1875PubMedCrossRefGoogle Scholar
  9. Kartalis N, Lindholm TL, Aspelin P et al (2009) Diffusion-weighted magnetic resonance imaging of pancreas tumours. Eur Radiol 19:1981–1990PubMedCrossRefGoogle Scholar
  10. Klauss M, Lemke A, Grünberg K et al (2011) Intravoxel incoherent motion MRI for the differentiation between mass forming chronic pancreatitis and pancreatic carcinoma. Invest Radiol 46(1):57–63PubMedCrossRefGoogle Scholar
  11. Lee SS, Byun JH, Park BJ et al (2008) Quantitative analysis of diffusion-weighted magnetic resonance imaging of the pancreas: usefulness in characterizing solid pancreatic masses. J Magn Reson Imaging 28(4):928–936PubMedCrossRefGoogle Scholar
  12. Lemke A, Laun FB, Klau M et al (2009). Differentiation of pancreas carcinoma from healthy pancreatic tissue using multiple b-values: comparison of apparent diffusion coefficient and intravoxel incoherent motion derived parameters. Invest Radiol; Oct 15, 2009 [Epub ahead of print]Google Scholar
  13. Masselli G, Manfredi R, Vecchioli A et al (2008) MR ­imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings. Eur Radiol 18:2213–2221PubMedCrossRefGoogle Scholar
  14. Matsuki M, Inada Y, Nakai G et al (2007) Diffusion-weighted MR imaging of pancreatic carcinoma. Abdom Imaging 32(4):481–483PubMedCrossRefGoogle Scholar
  15. Muraoka N, Uematsu H, Kimura H et al (2008) Apparent diffusion coefficient in pancreatic cancer: characterization and histopathological correlations. J Magn Reson Imaging 27(6):1302–1308PubMedCrossRefGoogle Scholar
  16. Park HS, Lee JM, Choi JY et al (2008) Preoperative evaluation of bile duct cancer: MRI combined with MR cholangiopancreatography versus MDCT with direct cholangiography. Am J Roentgenol 190:396–405CrossRefGoogle Scholar
  17. Shinya S, Sasaki T, Nakagawa Y et al (2009) The efficacy of diffusion-weighted imaging for the detection and evaluation of acute pancreatitis. Hepatogastroenterology 56(94–95):1407–1410PubMedGoogle Scholar
  18. Taniguchi T, Kobayashi H, Nishikawa K et al (2009) Diffusion-weighted magnetic resonance imaging in autoimmune pancreatitis. Jpn J Radiol 27(3):138–142PubMedCrossRefGoogle Scholar
  19. Yoshikawa T, Kawamitsu H, Mitchell DG et al (2006) ADC measurement of abdominal organs and lesions using parallel imaging technique. Am J Roentgenol 187(6):1521–1530CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Jorge A. Soto
    • 1
    Email author
  • German A. Castrillon
    • 2
  • Stephan Anderson
    • 1
  • Nagaraj Holalkere
    • 1
  1. 1.Radiology DepartmentBoston University School of MedicineBostonUSA
  2. 2.Radiology DepartmentUniversity of AntioquiaMedellinColombia

Personalised recommendations