Original article
Abdominal imaging
Differentiation between hepatic alveolar echinococcosis and primary hepatic malignancy with diffusion-weighted magnetic resonance imaging

https://doi.org/10.1016/j.diii.2017.09.007Get rights and content
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Abstract

Purpose

To determine the value of diffusion-weighted magnetic resonance imaging (DW-MRI) in discriminating between hepatic alveolar echinococcosis (AE) and hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

Methods

We included 49 patients (27 men, 22 women; mean age: 52.02 ± 9.76 [SD] years; range: 25–72 years) with 57 histopathologically confirmed hepatic AE lesions. Fifty patients (18 men, 32 women; mean age: 58.93 ± 8.42 [SD] years; range: 42–71 years) with 61 histopathologically confirmed hepatocellular carcinoma and 50 patients (24 men, 26 women; mean age: 50.11 ± 7.70 [SD] years; range: 38–69 years) with 54 histopathologically confirmed intrahepatic cholangiocarcinoma lesions were used as control groups. All patients had MRI examination of the liver that included conventional MRI sequences and DW-MRI using b values of 50, 400 and 800 s/mm2. Two radiologists evaluated conventional MRI and DW-MRI images and calculated ADC values of hepatic lesions.

Results

The mean ADC value of solid components of hepatic AE lesions was 1.34 ± 0.41 × 10−3 mm2/s (range: 0.9–1.59 × 10−3 mm2/s) and was significantly higher than that of the solid components of hepatocellular carcinoma lesions (mean ADC value, 0.99 ± 0.29 × 10−3 mm2/s; range: 0.7–1.15 × 10−3 mm2/s) and of intrahepatic cholangiocarcinoma lesions (mean ADC value, 1.05 ± 0.22 × 10−3 mm2/s; range: 0.86–1.18 × 10−3 mm2/s) (P < 0.001).

Conclusion

In general ADC values can help discriminate between AE and hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, the use of ADC values cannot help differentiating Type 4 AE from hepatocellular carcinoma or intrahepatic cholangiocarcinoma.

Keywords

Diffusion magnetic resonance imaging
Alveolar echinococcosis
Apparent diffusion coefficient (ADC)
Hepatocellular carcinoma
Intrahepatic cholangiocarcinoma

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