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    The role of diffusion-weighted MRI in the classification of liver hydatid cysts and differentiation of simple cysts and abscesses from hydatid cysts
    (Aves, 2010) Oruc, Esra; Yildirim, Nalan; Topal, Naile Bolca; Kilicturgay, Sadik; Akgoz, Semra; Savci, Gursel
    PURPOSE The purpose of this study is to identify the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in the classification of liver hydatid cysts (HCs) and their differentiation from simple cysts and liver abscesses. MATERIALS AND METHODS Twenty-two patients that were sent to our department with preliminary diagnoses of HCs or abscess were included in the study. Thirty lesions were evaluated. MRI included T1-weighted fast gradient echo, T2-weighted half-Fourier acquisition single-shot turbo spin echo, and DW single-shot echo planar pulse sequencing (b, 0, 50, and 1000 s/mm(2)). The apparent diffusion coefficient (ADC) values (mm(2)/s) of the HCs, asscesses, and simple cysts were calculated. RESULTS No statistically significant difference was found between the ADC values of type 1 and 3 (P>0.05) HCs and of simple cysts and type 1 HCs (P>0.05). The ADC values of abscesses were significantly lower than those of type 1 and type 3 HCs, and simple cysts. No statistically significant difference was found between the ADC values of abscesses and type 4 HCs (P>0.05). Type 4 lesions exhibited significantly lower ADC values in comparison to type 1 and 3 HCs. CONCLUSION DW-MRI helps differentiate type 4 lesions from other cysts and can distinguish abscesses from hydatid cysts other than type 4 as well as from simple cysts. Type 1 HCs cannot be differentiated from simple cysts using ADC values alone, and type 4 lesions are indistinguishable from abscesses.