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Can diffusion-weighted imaging be used in the examination of peritoneal fluids?

Zeynep Keskin1

  • 1Konya City Hospital, Konya, Turkey.

Polish Journal of Radiology
|April 14, 2023
PubMed
Abstract

Insights

Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values effectively differentiate abdominal fluid infections. ADC values are higher in infective fluids, offering a reliable, non-invasive method for fluid characterization.

Area of Science:

  • Radiology
  • Medical Imaging
  • Diagnostic Imaging

Background:

  • Abdominal free fluid requires accurate etiological investigation.
  • Magnetic Resonance Imaging (MRI) is a key tool for evaluating abdominopelvic fluid.
  • Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values offer potential for fluid characterization.

Purpose of the Study:

  • To assess the effectiveness of DWI and ADC values in evaluating abdominopelvic fluids.
  • To determine the diagnostic performance of ADC values in distinguishing infective from non-infective fluids.

Main Methods:

  • Retrospective single-center study of 41 patients with abdominopelvic fluid on MRI.
  • Measurement of average ADC values in fluids, with paracentesis and fluid analysis for confirmation.
  • Calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for a determined ADC cut-off value.

Main Results:

  • ADC values were significantly higher in infective fluids compared to non-infective fluids (p < 0.001).
  • A cut-off ADC value of 2.95 × 10⁻³ mm²/s demonstrated 88% sensitivity and 93.8% specificity.
  • Positive predictive value (PPV) was 95.7% and negative predictive value (NPV) was 83.3% for distinguishing fluid types.

Conclusions:

  • Apparent diffusion coefficient (ADC) values are a reliable and reproducible imaging parameter.
  • ADC measurements provide a non-invasive method for evaluating and characterizing abdominal fluids.
  • DWI and ADC values can aid in differentiating infective from non-infective abdominopelvic fluid collections.
Keywords:
ADCDWIMRIbenignitymalignityperitoneal fluid

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