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Diffusion-Weighted MRI of Malignant versus Benign Portal Vein Thrombosis

Authors
 Jhii-Hyun Ahn  ;  Jeong-Sik Yu  ;  Eun-Suk Cho  ;  Jae-Joon Chung  ;  Joo Hee Kim  ;  Ki Whang Kim 
Citation
 KOREAN JOURNAL OF RADIOLOGY, Vol.17(4) : 533-540, 2016 
Journal Title
KOREAN JOURNAL OF RADIOLOGY
ISSN
 1229-6929 
Issue Date
2016
MeSH
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Carcinoma, Hepatocellular/diagnosis* ; Carcinoma, Hepatocellular/diagnostic imaging ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging* ; Female ; Humans ; Liver Neoplasms/diagnosis* ; Liver Neoplasms/diagnostic imaging ; Male ; Middle Aged ; Portal Vein/diagnostic imaging* ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Venous Thrombosis/diagnosis* ; Venous Thrombosis/diagnostic imaging
Keywords
Apparent diffusion coefficient ; Diagnosis ; Diffusion weighted MRI ; Hepatocellular carcinoma ; Hepatoma ; MRI ; Portal vein thrombosis
Abstract
OBJECTIVE: To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis.

MATERIALS AND METHODS: The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40-85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients. DWI was performed using b values of 50 and 800 sec/mm(2) at 1.5-T unit. A thrombus was considered malignant if it enhanced on dynamic CT or MRI; otherwise, it was considered bland. There were 18 bland thrombi and 49 malignant thrombi in 59 patients, including 8 patients with simultaneous benign and malignant PVT. Mean apparent diffusion coefficients (ADCs) of benign and malignant PVTs were compared by using Mann-Whitney U test. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS: The mean ADC ± standard deviation of bland and malignant PVT were 1.00 ± 0.39 × 10(-3) mm(2)/sec and 0.92 ± 0.25 × 10(-3) mm(2)/sec, respectively; without significant difference (p = 0.799). The area under ROC curve for ADC was 0.520. An ADC value of > 1.35 × 10(-3) mm(2)/sec predicted bland PVT with a specificity of 94.6% (95% confidence interval [CI]: 84.9-98.9%) and a sensitivity of 22.2% (95% CI: 6.4-47.6%), respectively.

CONCLUSION: Due to the wide range and considerable overlap of the ADCs, DWI cannot differentiate the benign from malignant thrombi efficiently.
Files in This Item:
T201604210.pdf Download
DOI
10.3348/kjr.2016.17.4.533
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Ahn, Jhii Hyun(안지현)
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
Cho, Eun Suk(조은석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152321
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