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Objective: To investigate MRI features and associated histological and pathological changes of hilar and extrahepatic big bile duct cholangiocarcinoma with different morphological sub-types, and its value in differentiating between nodular cholangiocarcinoma (NCC) and intraductal growing cholangiocarcinoma (IDCC)., Methods: Imaging data of 152 patients with pathologically confirmed hilar and extrahepatic big bile duct cholangiocarcinoma were reviewed, which included 86 periductal infiltrating cholangiocarcinoma (PDCC), 55 NCC, and 11 IDCC. Imaging features of the three morphological sub-types were compared., Results: Each of the subtypes demonstrated its unique imaging features. Significant differences (P < 0.05) were found between NCC and IDCC in tumor shape, dynamic enhanced pattern, enhancement degree during equilibrium phase, multiplicity or singleness of tumor, changes in wall and lumen of bile duct at the tumor-bearing segment, dilatation of tumor upstream or downstream bile duct, and invasion of adjacent organs., Conclusion: Imaging features reveal tumor growth patterns of hilar and extrahepatic big bile duct cholangiocarcinoma. MRI united-sequences examination can accurately describe those imaging features for differentiation diagnosis.

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.

Objective: To explore the diagnostic value of the system serial of three-dimensional spoiled gradient-echo T1-weighted MR imaging (three-dimensional volumetric interpolated breath-hold examination, 3D-VIBE) used to the preoperative assessment of hepatic portal cholangiocarcinoma., Methods: 31 surgically confirmed patients with hepatic portal cholangiocarcinoma underwent the preoperative examination through MR imaging system serial that was including T2W, two dimension (2D) T1W plain scan, 2D magnetic resonance cholangiopancreatography (MRCP), and Gadolinium-enhanced 3D-VIBE triple-phase dynamic acquisitions followed by 2D T1W scanning at the equilibrium phase. Meanwhile, it was performed for focusing on assessing or judging the tumor morphological type, the longitudinal infiltration extent of the bile duct and the involvement of neighbor blood vessels. And the 3D-VIBE was compared with 2D T1W systems for assessing or judging the tumor resectability., Results: (1) (3D-VIBE directly displayed the hepatic portal tumors and correctly classified the tumor morphological types in all patients, but 2D T1W systems missed to show 8 hepatic portal cholangiocarcinoma of periductal-infiltrating type (25. 8%); (2) According to Bismuth-Corlette classification, 3D-VIBE was closed to MRCP in accuracy (93.5%) for showing the longitudinal infiltration extent of tumor, but 2D T1W system serial underestimated (32.3%) the extent. (3) 3D-VIBE showed more involvement of the main trunk of hepatic artery, portal vein and their branches than 2D T1W systems did. (4) The positive predicting value and accuracy for assessing tumor resectability were 84.0% and 90.0% for 3D-VIBE system, as 64.0% and 71.0% for 2D T1W systems., Conclusion: 3D-VIBE system is superior to other MR imaging system serial in the preoperative assessment of the morphological type, the longitudinal infiltration extent and the tumor resectability of hepatic portal cholangiocarcinoma.

Objective: Although diffusion-weighted magnetic resonance imaging (DWI) has been widely used in the diagnosis of cervical cancer, whether it can predict disease recurrence or survival remains inconclusive. This study aimed to systematically evaluate whether DWI can serve as a reliable prognostic predictor in patients with cervical cancer.Methods: PubMed, the MEDLINE database and the Cochrane Library were searched for DWI studies with >12 months of prognostic data in patients with cervical cancer. Endpoints included tumor recurrence and death. Methodological quality was assessed using the Quality in Prognostic Studies (QUIPS) tool. Combined estimates of hazard ratios (HRs) were derived.Results: Nine studies involving a total of 796 patients (mean/median age from 45.0 years to 62.9 years) met the inclusion criteria. Methodological quality was relatively high. Eight of the nine studies employed apparent diffusion coefficient (ADC) as an indicator of DWI results. Using disease-free survival (DFS) as an outcome measure, nine studies yielded a combined HR of 1.55 (95% confidence interval (CI): 1.23-1.95), and seven studies that employed pretreatment DWI yielded a combined HR of 1.50 (95% CI: 1.03-2.19), which indicated that unfavorable DWI results were associated with an approximately 1.50-1.55-fold higher risk of tumor recurrence. The two studies investigating the impact of DWI results on overall survival (OS) reported HRs of 7.20 and 2.17, respectively.Conclusion: DWI may serve as a predictor of tumor recurrence in patients with cervical cancer as showed by meta-analysis, and the quantified ADC as a suitable candidate indicator. [ABSTRACT FROM AUTHOR]