The role of combined diffusion weighted imaging and magnetic resonance cholangiopancreatography in the differential diagnosis of obstructive biliary disorders

Abstract

Abstract Background The aim of this retrospective study was to highlight the role of adding DWI to the conventional MRCP in differentiating benign and malignant obstructive biliary pathologies. MRCP is a non-invasive modality for investigating the morphological features of the pancreaticobiliary system. It can provide indirect evidence of a malignant lesion, such as irregularity of the inner border and abrupt stenosis, with shouldering of the edge suggesting cholangiocarcinoma, while a short segment with regular margin and symmetric narrowing suggests a benign cause. Although these findings are highly sensitive, they are not specific. DWI can complement morphological information obtained by conventional MRCP by providing additional functional information concerning the alteration of tissue cellularity due to pathological processes. Results The overall accuracy of the diagnosis, sensitivity, and specificity of the conventional MRCP in differentiation between the benign and malignant biliary structures was significantly increased by combing it with the DWI. Conclusions Adding DWI to conventional MRCP significantly improved the diagnostic accuracy regarding the characterization of differentiating benign and malignant biliary strictures.