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Differentiation of benign and malignant ampullary obstructions on MR imaging.

Authors
 Yong Eun Chung ; Myeong-Jin Kim ; Hye-Suk Hong ; Ki Whang Kim ; Jin-Young Choi ; Mi-Suk Park ; Hye Mi Kim 
Citation
 European Journal of Radiology, Vol.80(2) : 198~203, 2011 
Journal Title
 European Journal of Radiology 
ISSN
 0720-048X 
Issue Date
2011
Abstract
OBJECTIVE: To define diagnostic criteria for differentiating malignant ampullary carcinoma from benign ampullary obstruction on MR imaging. MATERIALS AND METHODS: Nineteen patients with ampullary carcinoma and 22 patients with benign ampullary obstruction were enrolled. At the first session, two radiologists independently evaluated specific imaging findings, and then reached consensus decisions. At the second session, another two radiologists, who were informed about useful differentiation criteria based on the results from the first session, reviewed images and determined the causes of ampullary obstruction. Sensitivity and specificity were calculated for each interpretation session, and the Cohen κ statistic was used to evaluate interobserver agreement. RESULTS: Findings of the presence of an ampullary mass (P<0.001), papillary bulging (P<0.001), irregular (P=0.021) and asymmetric (P<0.001) common bile duct (CBD) narrowing, and proportional biliary dilatation (P<0.001) were more commonly seen in patients with an ampullary carcinoma. The sensitivity and specificity of the first session were 84.2% and 86.4% after consensus. The sensitivity increased to 100% for both the readers at the second session, while the specificity decreased to 63.6% and 59.1%, respectively. CONCLUSIONS: Identification of an ampullary mass, papillary bulging, irregular and asymmetric narrowing of the CBD, or proportional biliary dilatation may improve the diagnosis of ampullary carcinoma in patients with ampullary obstruction.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/94411
DOI
10.1016/j.ejrad.2010.04.017
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
Yonsei Authors
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Link
 http://www.sciencedirect.com/science/article/pii/S0720048X10001816
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