Diffusion-Weighted Imaging in the Differential Diagnosis of Simple and Hydatid Cysts of the Liver

The purpose of our study was to evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of simple and hydatid cysts of the liver, particularly in the completely liquid type of hydatid cyst. Eighty-two cysts (43 simple cysts, 39 hydatid cysts) were included in this prospe...

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Published inAmerican journal of roentgenology (1976) Vol. 189; no. 5; pp. 1031 - 1036
Main Authors Inan, Nagihan, Arslan, Arzu, Akansel, Gur, Anik, Yonca, Sarisoy, H. Tahsin, Ciftci, Ercument, Demirci, Ali
Format Journal Article
LanguageEnglish
Published Leesburg, VA Am Roentgen Ray Soc 01.11.2007
American Roentgen Ray Society
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Summary:The purpose of our study was to evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of simple and hydatid cysts of the liver, particularly in the completely liquid type of hydatid cyst. Eighty-two cysts (43 simple cysts, 39 hydatid cysts) were included in this prospective study. DWI was performed using a breath-hold single-shot echo-planar spin-echo sequence, and apparent diffusion coefficients (ADCs) were calculated. On DW trace images, the signal intensity of cysts was visually compared with the signal intensity of the liver using a 3-point scale: 0, isointense; 1, moderately hyperintense; and 2, significantly hyperintense. Quantitatively, signal intensity of the cysts, cyst-to-liver signal intensity ratios, ADC of the cysts, and cyst-to-liver ADC ratios were compared between the groups. The statistical significance was determined using the Mann-Whitney U test. On trace DWI (b = 1,000 s/mm2), most hydatid cysts (37/39, 95%) were hyperintense, whereas most simple cysts (40/43, 93%) were isointense with the liver. Three simple cysts (7%) were moderately hyperintense and two hydatid cysts (5%) were isointense. Quantitatively, both the signal intensity and cyst-to-liver signal intensity ratio of the hydatid cysts were significantly higher than those for simple cysts (p < 0.001). The cutoff value at 1.5 yielded a sensitivity of 77%, a specificity of 86%, and positive predictive value of 83% for the cyst-to-liver signal intensity ratio. The ADC and cyst-to-liver ADC ratio of the hydatid cysts were significantly lower than those of simple cysts (p < 0.005). For the completely liquid type in particular, we observed statistically significant differences in signal intensity, signal intensity ratio, ADC, and ADC ratios from those of simple cysts (p < 0.005). With a cutoff value of 1.5, signal intensity ratio had a sensitivity of 81%, specificity of 86%, and positive predictive value of 74%. DWI may help in the differential diagnosis of hydatid and simple cysts of the liver.
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ISSN:0361-803X
1546-3141
DOI:10.2214/AJR.07.2251