Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis

Annie Wang, Alampady K. Shanbhogue, Diane Dunst, Cristina H. Hajdu, Andrew B. Rosenkrantz

Research output: Contribution to journalArticle

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Abstract

Purpose: To assess the use of diffusion-weighted imaging (DWI) for differentiating acute from chronic cholecystitis, in comparison with conventional magnetic resonance imaging (MRI) features. Materials and Methods: Liver MRI including DWI (b-values 0/500/1000s/mm2) was performed at 1.5T ≤30 days before cholecystectomy in 83 patients with abdominal pain. Two radiologists assessed cases for conventional (gallstones, wall thickening, pericholecystic fluid, pericholecystic fat changes, gallbladder distension, pericholecystic liver enhancement, mural T2-hyperintensity, mural hyperenhancement, mural striations, abscess, intraluminal membranes, and mural defect) and DWI (increased mural signal on high b-value images, visually low apparent diffusion coefficient [ADC], and ADC values) features. Results: Acute cholecystitis was present in 43%; chronic cholecystitis was present in 57%. Nine of 12 conventional features were more frequent in acute cholecystitis for both readers (P ≤ 0.003). Increased mural signal on high b-value images was more frequent (P < 0.001) in acute than chronic cholecystitis for R1 (92% vs. 32%) and R2 (83% vs. 30%). Sensitivity and specificity of increased signal on high b-value images were: R1, 92%/68%; R2, 83%/70%. Visually low ADC was more frequent in acute cholecystitis for R2 (P < 0.001) but not R1 (P = 0.406); ADC values were not different between groups for either reader (P = 0.104–0.139). Among conventional and DWI features, only increased signal on high b-value DWI was independently associated with acute cholecystitis for both readers (P = 0.006–0.012). Conclusion: Visually increased mural signal on high b-value DWI was highly sensitive and moderately specific for acute cholecystitis, being an independent predictor relative to conventional features for both readers. Although requiring larger studies, DWI (particularly the high b-value images) may have additive value relative to conventional MRI-suspected acute cholecystitis. J. Magn. Reson. Imaging 2016;44:89–97.

Original languageEnglish (US)
Pages (from-to)89-97
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Volume44
Issue number1
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

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Acute Cholecystitis
Diffusion Magnetic Resonance Imaging
Magnetic Resonance Imaging
Cholecystitis
Liver
Cholecystectomy
Gallstones
Gallbladder
Abscess
Abdominal Pain
Fats
Sensitivity and Specificity

Keywords

  • apparent diffusion coefficient
  • cholecystitis
  • diffusion-weighted imaging
  • gallbladder
  • MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis. / Wang, Annie; Shanbhogue, Alampady K.; Dunst, Diane; Hajdu, Cristina H.; Rosenkrantz, Andrew B.

In: Journal of Magnetic Resonance Imaging, Vol. 44, No. 1, 01.07.2016, p. 89-97.

Research output: Contribution to journalArticle

Wang, Annie ; Shanbhogue, Alampady K. ; Dunst, Diane ; Hajdu, Cristina H. ; Rosenkrantz, Andrew B. / Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis. In: Journal of Magnetic Resonance Imaging. 2016 ; Vol. 44, No. 1. pp. 89-97.
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abstract = "Purpose: To assess the use of diffusion-weighted imaging (DWI) for differentiating acute from chronic cholecystitis, in comparison with conventional magnetic resonance imaging (MRI) features. Materials and Methods: Liver MRI including DWI (b-values 0/500/1000s/mm2) was performed at 1.5T ≤30 days before cholecystectomy in 83 patients with abdominal pain. Two radiologists assessed cases for conventional (gallstones, wall thickening, pericholecystic fluid, pericholecystic fat changes, gallbladder distension, pericholecystic liver enhancement, mural T2-hyperintensity, mural hyperenhancement, mural striations, abscess, intraluminal membranes, and mural defect) and DWI (increased mural signal on high b-value images, visually low apparent diffusion coefficient [ADC], and ADC values) features. Results: Acute cholecystitis was present in 43{\%}; chronic cholecystitis was present in 57{\%}. Nine of 12 conventional features were more frequent in acute cholecystitis for both readers (P ≤ 0.003). Increased mural signal on high b-value images was more frequent (P < 0.001) in acute than chronic cholecystitis for R1 (92{\%} vs. 32{\%}) and R2 (83{\%} vs. 30{\%}). Sensitivity and specificity of increased signal on high b-value images were: R1, 92{\%}/68{\%}; R2, 83{\%}/70{\%}. Visually low ADC was more frequent in acute cholecystitis for R2 (P < 0.001) but not R1 (P = 0.406); ADC values were not different between groups for either reader (P = 0.104–0.139). Among conventional and DWI features, only increased signal on high b-value DWI was independently associated with acute cholecystitis for both readers (P = 0.006–0.012). Conclusion: Visually increased mural signal on high b-value DWI was highly sensitive and moderately specific for acute cholecystitis, being an independent predictor relative to conventional features for both readers. Although requiring larger studies, DWI (particularly the high b-value images) may have additive value relative to conventional MRI-suspected acute cholecystitis. J. Magn. Reson. Imaging 2016;44:89–97.",
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N2 - Purpose: To assess the use of diffusion-weighted imaging (DWI) for differentiating acute from chronic cholecystitis, in comparison with conventional magnetic resonance imaging (MRI) features. Materials and Methods: Liver MRI including DWI (b-values 0/500/1000s/mm2) was performed at 1.5T ≤30 days before cholecystectomy in 83 patients with abdominal pain. Two radiologists assessed cases for conventional (gallstones, wall thickening, pericholecystic fluid, pericholecystic fat changes, gallbladder distension, pericholecystic liver enhancement, mural T2-hyperintensity, mural hyperenhancement, mural striations, abscess, intraluminal membranes, and mural defect) and DWI (increased mural signal on high b-value images, visually low apparent diffusion coefficient [ADC], and ADC values) features. Results: Acute cholecystitis was present in 43%; chronic cholecystitis was present in 57%. Nine of 12 conventional features were more frequent in acute cholecystitis for both readers (P ≤ 0.003). Increased mural signal on high b-value images was more frequent (P < 0.001) in acute than chronic cholecystitis for R1 (92% vs. 32%) and R2 (83% vs. 30%). Sensitivity and specificity of increased signal on high b-value images were: R1, 92%/68%; R2, 83%/70%. Visually low ADC was more frequent in acute cholecystitis for R2 (P < 0.001) but not R1 (P = 0.406); ADC values were not different between groups for either reader (P = 0.104–0.139). Among conventional and DWI features, only increased signal on high b-value DWI was independently associated with acute cholecystitis for both readers (P = 0.006–0.012). Conclusion: Visually increased mural signal on high b-value DWI was highly sensitive and moderately specific for acute cholecystitis, being an independent predictor relative to conventional features for both readers. Although requiring larger studies, DWI (particularly the high b-value images) may have additive value relative to conventional MRI-suspected acute cholecystitis. J. Magn. Reson. Imaging 2016;44:89–97.

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KW - apparent diffusion coefficient

KW - cholecystitis

KW - diffusion-weighted imaging

KW - gallbladder

KW - MRI

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