Dynamic MRI of the gallbladder lesions: Differentiation of benign from malignant

Abstract

Forty-nine pathologically proven gallbladder lesions were evaluated in 45 patients using dynamic MRI with a spoiled gradient pulse sequence (SPGR), to access the ability of this technique to differentiate benign from malignant gallbladder lesions. The studies were reviewed retrospectively. Signal intensity of the lesions were measured. Twenty-one malignant and 28 benign lesions were classified into three categories: polypoid, diffuse wall thickening, and exophytic. Early and delayed enhancement patterns were evaluated. For the polypoid masses, malignant lesions (n = 9) demonstrated early and prolonged enhancements, whereas benign lesions (n = 14) had early enhancement with subsequent washout (P < .05). For diffuse gallbladder wall thickening, malignant lesions (n = 6) demonstrated early and prolonged enhancement and benign lesions (n = 14) showed relatively slow, prolonged enhancement (P < .05). The exophytic masses (n = 6) all were malignant and demonstrated early and prolonged enhancement. Dynamic MRI can help differentiate benign from malignant gallbladder lesions.

Role of Magnetic Resonance Cholangiopancreatography in Biliary Disorders

“…Malignant lesions demonstrate early and prolonged enhancement where as benign lesion show different pattern. Dynamic MRI can also be useful for differentiation of chronic cholecystitis from carcinoma and for evaluation of weather the tumour invades beyond serosa [10].…”

MRI of gallbladder cancer

“…4). Enhancement in GBCA is usually irregular, occurs early and remains prolonged (17,18). Hence, high resolution T2 and arterial phased contrast enhanced images are most useful in differentiating GBCA from inflammatory wall thickening.…”

Diagnosis of Gallbladder Tumors

“…However, recent advances in instrumentation have improved the spatial and contrast resolution and also the signal-to-noise ratio (13). Yoshimitsu et al (14) reported the usefulness of dynamic magnetic resonance imaging for differentiating benign from malignant gallbladder lesions. Among polypoid masses, malignant lesions (n=9) demonstrated early and prolonged enhancements, while benign lesions (n=14) showed early enhancement with subsequent washout.…”