Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2015; 21(25): 7824-7833
Published online Jul 7, 2015. doi: 10.3748/wjg.v21.i25.7824
Gd-EOB-DTPA-enhanced magnetic resonance imaging for bile duct intraductal papillary mucinous neoplasms
Shi-Hong Ying, Xiao-Dong Teng, Zhao-Ming Wang, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao
Shi-Hong Ying, Qi-Dong Wang, Yi-Lei Zhao, Feng Chen, Wen-Bo Xiao, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Xiao-Dong Teng, Zhao-Ming Wang, Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Ying SH, Chen F and Xiao WB designed the research; Ying SH, Teng XD and Wang QD performed the research; Wang ZM and Zhao YL analyzed the data; Ying SH, Chen F and Xiao WB wrote the paper; all authors approved the final version for publication.
Supported by National Natural Science Foundation of China, No. 81171388; and Ministry of Health Research Foundation of China (in part), No. WKJ2011-2-004.
Ethics approval: The study was a retrospective study, and every patient had undergone ethoxybenzyl-enhanced magnetic resonance imaging according to clinical routine.
Informed consent statement: Informed written consent was obtained from all patients.
Conflict-of-interest statement: Authors have no conflicts of interest for this paper.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Wen-Bo Xiao, MD, Chief Doctor, Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China.
Telephone: +86-571-87236587 Fax: +86-571-87236587
Received: December 14, 2014
Peer-review started: December 18, 2014
First decision: January 22, 2015
Revised: February 20, 2015
Accepted: April 17, 2015
Article in press: April 17, 2015
Published online: July 7, 2015

AIM: To investigate gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) of intraductal papillary mucinous neoplasms of the bile duct (IPMN-B).

METHODS: The imaging findings of five cases of IPMN-B which were pathologically confirmed at our hospital between March 2012 and May 2013 were retrospectively analyzed. Three of these cases were diagnosed by duodenal endoscopy and biopsy pathology, and two cases were diagnosed by surgical pathology. All five patients underwent enhanced and non-enhanced computed tomography (CT), magnetic resonance cholangiopancreatography, and Gd-EOB-DTPA-enhanced MRI; one case underwent both Gd-EOB-DTPA-enhanced MRI and positron emission tomography-CT. The clinical data and imaging results for these cases were compared and are presented.

RESULTS: Conventional imaging showed diffuse dilatation of bile ducts and multiple intraductal polypoid and papillary neoplasms or serrated changes along the bile ducts. In two cases, Gd-EOB-DTPA-enhanced MRI revealed dilated biliary ducts and intraductal tumors, as well as filling defects caused by mucin in the dilated bile ducts in the hepatobiliary phase. Gd-EOB-DTPA-enhanced MRI in one case clearly showed a low-signal tumor in the hepatobiliary phase, similar to what was seen by positron emission tomography-CT. In two patients, routine inspection was unable to discern whether the lesions were inflammation or tumors. However, Gd-EOB-DTPA-enhanced MRI revealed a pattern of gradual enhancement during the hepatobiliary phase, and the signal intensity of the lesions was lower than the surrounding liver parenchyma, suggesting tissue inflammation in both cases, which were confirmed by surgical pathology.

CONCLUSION: Gd-EOB-DTPA-enhanced MRI reveals the intraductal mucin component of IPMN-B in some cases and the extent of tumor infiltration beyond the bile ducts in invasive cases.

Keywords: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid, Magnetic resonance imaging, Magnetic resonance cholangiopancreatography, Multidetector computed tomography, Bile duct neoplasms

Core tip: Gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) can be used to demonstrate the filling defects due to mucin secreted by intraductal papillary mucinous neoplasms of the bile duct (IPMN-B) and to display the extent of tumor infiltration beyond bile ducts in cases with invasive IPMN-B. It also has the potential to differentiate tumor tissue from inflammatory lesions. Therefore, Gd-EOB-DTPA-enhanced MRI may improve the clinical management of IPMN-B.