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Periampullary Tumors: High-Spatial-Resolution MR Imaging and Histopathologic Findings in Ampullary Region Specimens¹

¹ From the Department of Radiology, NTT East Tohoku Hospital, 2–29-1, Yamatomachi Wakabayashi-ku, Sendai, Japan (R.S., A.F.); Department of Gastroenterology, Sendai City Medical Center, Japan (K.I., N.F.); Department of Pathology, Tohoku University School of Dentistry, Sendai, Japan (R.I.); and Department of Radiology, Tohoku University School of Medicine, Sendai, Japan (S.T.). Received May 12, 2003; revision requested July 22; revision received October 20; accepted December 9. Address correspondence to R.S. (e-mail: reiji.s@thk.mhc.east.ntt.co.jp).

PURPOSE: To prospectively determine the magnetic resonance (MR) signal intensity characteristics of structures of the ampullary region and to assess the potential use of MR imaging in evaluation of the extent of periampullary tumors in resected specimens.

MATERIALS AND METHODS: Twenty-five specimens from the ampullary region obtained in four autopsy cases without periampullary tumors and in 21 patients with periampullary tumors were examined with a 1.5-T MR system and a circular surface coil with 5-inch (12.7-cm) diameter. High-spatial-resolution MR images were obtained with field of view of 100 x 100 mm, matrix of 256 x 256 or 512 x 256, and section thickness of 2 mm. MR imaging findings were compared with histopathologic findings. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of high-spatial-resolution MR imaging for assessment of tumor invasion into surrounding tissues were evaluated by two radiologists.

RESULTS: T1- and T2-weighted MR images clearly depicted normal structures in the ampullary region that included Oddi muscle, duodenal wall, common bile duct, and pancreas; these findings corresponded well with histologic findings. In 20 (95%) of 21 tumors, high-spatial-resolution MR imaging depicted location and extension of periampullary tumors precisely. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of high-spatial-resolution MR imaging for assessment of tumor invasion into surrounding tissue were 88%, 100%, 96%, 100%, and 94%, respectively.

CONCLUSION: In this study, MR imaging correctly depicted location, extension, and origin of tumor. High-spatial-resolution MR imaging has potential for presurgical staging of tumors in this region.

© RSNA, 2004

Index terms: Bile ducts, neoplasms, 76.32, 767.32 • Duodenum, neoplasms, 73.32 • Pancreas, neoplasms, 77.32 • Specimens, MR, 73.121411, 76.121411, 77.121411

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