Review
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World J Gastroenterol. Aug 21, 2012; 18(31): 4102-4117
Published online Aug 21, 2012. doi: 10.3748/wjg.v18.i31.4102
Diffusion-weighted imaging of biliopancreatic disorders: Correlation with conventional magnetic resonance imaging
Nam Kyung Lee, Suk Kim, Gwang Ha Kim, Dong Uk Kim, Hyung Il Seo, Tae Un Kim, Dae Hwan Kang, Ho Jin Jang
Nam Kyung Lee, Suk Kim, Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, School of Medicine, Pusan National University, Busan 602-739, South Korea
Gwang Ha Kim, Dong Uk Kim, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, School of Medicine, Pusan National University, Busan 602-739, South Korea
Hyung Il Seo, Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, School of Medicine, Pusan National University, Busan 602-739, South Korea
Tae Un Kim, Department of Radiology, Yangsan Pusan National University Hospital, School of Medicine, Pusan National University, Yangsan 626-770, South Korea
Dae Hwan Kang, Department of Internal Medicine, Yangsan Pusan National University Hospital, School of Medicine, Pusan National University, Yangsan 626-770, South Korea
Ho Jin Jang, Department of Obstetrics and Gynecology, Armed Forces Seoul Hospital, Seoul 110-200, South Korea
Author contributions: Kim S contributed conception and design; Lee NK, Kim GH, Kim DU, Seo HI, Kim TU, Kang DH and Jang HJ acquired and interpreted data; Lee NK and Kim S wrote the article and revised it critically for important intellectual content; Kim S finally approved the revision to be published.
Supported by Clinical research grant from Pusan National University Hospital
Correspondence to: Suk Kim, MD, Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, School of Medicine, Pusan National University, No.1-10, Ami-Dong, Seo-Gu, Busan 602-739, South Korea. kimsuk@medimail.co.kr
Telephone: +82-51-2407354 Fax: +82-51-2447534
Received: December 9, 2011
Revised: April 26, 2012
Accepted: May 6, 2012
Published online: August 21, 2012
Abstract

Diffusion-weighted magnetic resonance imaging (DWI) is a well established method for the evaluation of intracranial diseases, such as acute stroke. DWI for extracranial application is more difficult due to physiological motion artifacts and the heterogeneous composition of the organs. However, thanks to the newer technical development of DWI, DWI has become increasingly used over the past few years in extracranial organs including the abdomen and pelvis. Most previous studies of DWI have been limited to the evaluation of diffuse parenchymal abnormalities and focal lesions in abdominal organs, whereas there are few studies about DWI for the evaluation of the biliopancreatic tract. Although further studies are needed to determine its performance in evaluating bile duct, gallbladder and pancreas diseases, DWI has potential in the assessment of the functional information on the biliopancreatic tract concerning the status of tissue cellularity, because increased cellularity is associated with impeded diffusion, as indicated by a reduction in the apparent diffusion coefficient. The detection of malignant lesions and their differentiation from benign tumor-like lesions in the biliopancreatic tract could be improved using DWI in conjunction with findings obtained with conventional magnetic resonance cholagiopancreatography. Additionally, DWI can be useful for the assessment of the biliopancreatic tract in patients with renal impairment because contrast-enhanced computed tomography or magnetic resonance scans should be avoided in these patients.

Keywords: Magnetic resonance imaging; Diffusion-weighted imaging; Biliary tract; Gallbladder; Pancreas