简介：AIM:Todeterminetheclinicalvalueofdiffusion-weight-edimaging(DWI)forthediagnosisofextrahepaticcholangiocarcinoma(EHCC)bycomparingthediagnosticsensitivityofDWIandmagneticresonancecholan-giopancreatography(MRCP).METHODS:Magneticresonanceimagingexaminationwasperformedin56patientswithsuspectedEHCC.T1-weightedimaging,T2-weightedimaging,MRCPandDWIsequence,DWIusingsingle-shotspin-echoechoplanarimagingsequencewithdifferentbvalues(100,300,500,800and1000s/mm2),wereperformed.Allcaseswerefurtherconfirmedbysurgeryorhistopathologicaldiagnosis.TworadiologistsjointlyperformedtheanalysisoftheDWIandMRCPimages.Apparentdiffusioncoefficient(ADC)valueandsignal-noiseratiowerecalculatedforEHCC.Sensitivity,specificity,accuracy,positivepredictivevalueandnegativepredictivevalueweretestedusingDWIwithabvalueof500s/mm2andMRCPimages,respectively.RESULTS:Histopathologicaldiagnosisconfirmedthatamongthe56cases,35wereEHCC(20hilarand15distalextrahepatic),16werecholangitis,and5werecal-culusofbileduct.Thirty-threeoutofthe35EHCCcasesweredetectedbyDWI.EHCCexhibiteddifferentiallevelsofhighsignalintensityinDWIandlowsignalintensityintheADCmap.ThemeanvalueforADCwas(1.31±0.29)×10-3mm2/s.ThedetectionrateofEHCCwassignificantlyhigherbyDWI(94.3%)thanbyMRCP(74.3%)(P<0.05).Therewasasignificantdifferenceinsensitivity(94.3%vs74.3%),specificity(100%vs71.4%),accu-racy(96.4%vs73.2%),positivepredictivevalue(100%vs81.3%),andnegativepredictivevalue(91.3%vs62.5%)betweenDWIandMRCPindiagnosingEHCC.CONCLUSION:DWIhasahighsensitivityforthedetectionofEHCCasitshowstheEHCClesionmoreunambiguouslythanMRCPdoes.DWIcanalsoprovideadditionalclinicallyimportantinformationinEHCCpatientswhenaddedtoroutinebileductMRimagingprotocols.

简介：关于为心脏性的吃惊的处理的levosimendan的使用的编辑的一封信被介绍。