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Hilar cholangiocarcinoma: preoperative evaluation with a three dimensional volumetric interpolated breath-hold examination magnetic resonance imaging sequence.
Chin Med J (Engl). 2007 Apr 20; 120(8):636-42.CM

Abstract

BACKGROUND

Early detection and accurate staging are crucial for planning treatment and improving survival rate of hilar cholangiocarcinomas. This study investigated the diagnostic value of a three dimensional, spoiled gradient echo, T1-weighted magnetic resonance (MR) imaging sequence (3D volumetric interpolated breath-hold examination, 3D-VIBE) in the preoperative evaluation of hilar cholangiocarcinoma.

METHODS

Thirty-one patients with surgically and histologically confirmed hilar cholangiocarcinomas underwent preoperative MR imaging examination. Unenhanced two-dimensional T1- and T2-weighted images, 2D MR cholangiopancreatographs (MRCP), gadolinium enhanced 3D-VIBE images in the early arterial, late arterial and portal venous phases followed by 2D T1-weighted images in the equilibrium phase were acquired. Images from 3D-VIBE, 2D T1-weighted enhanced sequences and 2D MRCP were interpreted by two abdominal radiologists through consensus reading in blind manner, focussing on the assessment of the morphological type, the longitudinal extent of tumor infiltration in the bile ducts and the involvement of neighbouring blood vessels. The accuracy of 3D-VIBE and 2D T1-weighted enhanced sequences in assessing the tumor resectability was compared.

RESULTS

All the 31 tumors were directly displayed and accurately classified on 3D-VIBE images whereas 8 periductal infiltrating tumors (8/31, 25.8%) were not depicted on 2D T1-weighted enhanced images. Using the Bismuth Corlette classification, 3D-VIBE was closer to MRCP in delineating the intraductal extent of tumor infiltration than 2D T1-weighted enhanced (28/31, 90.3%; 10/31, 32.3%; chi2 = 22.0, P < 0.05). Involvement of the hepatic artery, the portal venous trunk and their branches was shown more frequently on 3D VIBE than 2D T1-weighted enhanced images. The positive predictive value and accuracy of 3D-VIBE (84.2%; 90.3%) for assessing tumor resectability were higher than those of 2D T1-weighted enhanced images (64.0%; 71.0%, all P < 0.05).

CONCLUSION

Gadolinium enhanced 3D-VIBE is better than 2D T1-weighted enhanced sequence in the preoperative assessment of the morphologicalal type, the intraductal infiltrating extent and the tumor resectability of hilar cholangiocarcinomas.

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Authors+Show Affiliations

Yin LL
Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
Song B
No affiliation info available
Xu J
No affiliation info available
Li YC
No affiliation info available

MeSH

AdultAgedBile Duct NeoplasmsBile Ducts, IntrahepaticCholangiocarcinomaFemaleHumansImaging, Three-DimensionalMagnetic Resonance ImagingMaleMiddle AgedNeoplasm StagingPreoperative CareReproducibility of Results

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17517176

Citation

Yin, Long-Lin, et al. "Hilar Cholangiocarcinoma: Preoperative Evaluation With a Three Dimensional Volumetric Interpolated Breath-hold Examination Magnetic Resonance Imaging Sequence." Chinese Medical Journal, vol. 120, no. 8, 2007, pp. 636-42.
Yin LL, Song B, Xu J, et al. Hilar cholangiocarcinoma: preoperative evaluation with a three dimensional volumetric interpolated breath-hold examination magnetic resonance imaging sequence. Chin Med J (Engl). 2007;120(8):636-42.
Yin, L. L., Song, B., Xu, J., & Li, Y. C. (2007). Hilar cholangiocarcinoma: preoperative evaluation with a three dimensional volumetric interpolated breath-hold examination magnetic resonance imaging sequence. Chinese Medical Journal, 120(8), 636-42.
Yin LL, et al. Hilar Cholangiocarcinoma: Preoperative Evaluation With a Three Dimensional Volumetric Interpolated Breath-hold Examination Magnetic Resonance Imaging Sequence. Chin Med J (Engl). 2007 Apr 20;120(8):636-42. PubMed PMID: 17517176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hilar cholangiocarcinoma: preoperative evaluation with a three dimensional volumetric interpolated breath-hold examination magnetic resonance imaging sequence. AU - Yin,Long-Lin, AU - Song,Bin, AU - Xu,Juan, AU - Li,Ying-Chun, PY - 2007/5/23/pubmed PY - 2007/7/13/medline PY - 2007/5/23/entrez SP - 636 EP - 42 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 120 IS - 8 N2 - BACKGROUND: Early detection and accurate staging are crucial for planning treatment and improving survival rate of hilar cholangiocarcinomas. This study investigated the diagnostic value of a three dimensional, spoiled gradient echo, T1-weighted magnetic resonance (MR) imaging sequence (3D volumetric interpolated breath-hold examination, 3D-VIBE) in the preoperative evaluation of hilar cholangiocarcinoma. METHODS: Thirty-one patients with surgically and histologically confirmed hilar cholangiocarcinomas underwent preoperative MR imaging examination. Unenhanced two-dimensional T1- and T2-weighted images, 2D MR cholangiopancreatographs (MRCP), gadolinium enhanced 3D-VIBE images in the early arterial, late arterial and portal venous phases followed by 2D T1-weighted images in the equilibrium phase were acquired. Images from 3D-VIBE, 2D T1-weighted enhanced sequences and 2D MRCP were interpreted by two abdominal radiologists through consensus reading in blind manner, focussing on the assessment of the morphological type, the longitudinal extent of tumor infiltration in the bile ducts and the involvement of neighbouring blood vessels. The accuracy of 3D-VIBE and 2D T1-weighted enhanced sequences in assessing the tumor resectability was compared. RESULTS: All the 31 tumors were directly displayed and accurately classified on 3D-VIBE images whereas 8 periductal infiltrating tumors (8/31, 25.8%) were not depicted on 2D T1-weighted enhanced images. Using the Bismuth Corlette classification, 3D-VIBE was closer to MRCP in delineating the intraductal extent of tumor infiltration than 2D T1-weighted enhanced (28/31, 90.3%; 10/31, 32.3%; chi2 = 22.0, P < 0.05). Involvement of the hepatic artery, the portal venous trunk and their branches was shown more frequently on 3D VIBE than 2D T1-weighted enhanced images. The positive predictive value and accuracy of 3D-VIBE (84.2%; 90.3%) for assessing tumor resectability were higher than those of 2D T1-weighted enhanced images (64.0%; 71.0%, all P < 0.05). CONCLUSION: Gadolinium enhanced 3D-VIBE is better than 2D T1-weighted enhanced sequence in the preoperative assessment of the morphologicalal type, the intraductal infiltrating extent and the tumor resectability of hilar cholangiocarcinomas. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/17517176/Hilar_cholangiocarcinoma:_preoperative_evaluation_with_a_three_dimensional_volumetric_interpolated_breath_hold_examination_magnetic_resonance_imaging_sequence_ L2 - https://Insights.ovid.com/pubmed?pmid=17517176 DB - PRIME DP - Unbound Medicine ER -