Hepatobiliyer Hastalıklarda Tanıya Yönelik Görüntüleme Yöntemlerinden Endoskopik Retrograd Kolanjiopankreatografi ve Manyetik Rezonans Kolanjiopankreatografinin Etkinliğinin Karşılaştırılması

Öz

Amaç: Manyetik rezonans kolanjiopankreatografinin tanıya yönelik etkinliğini tanıda altın standart olarak kabul edilen endoskopik retrograd kolanjiopankreatografi ile kıyaslayarak değerlendirmeyi planladık. Gereç ve yöntem: Celal Bayar Üniversite hastanesi gastroenteroloji kliniğine 2012-2014 yılları arasında başvurup, Manyetik rezonans kolanjiopankreatografi ve sonrasında endoskopik retrograd kolanjiopankreatografi yapılan hastaların dosyaları retrospektif olarak incelendi Bulgular: Çalışmaya 53 erkek, 57 kadın toplam 110 hasta dâhil edildi. Hastaların ortalama yaşı 63,56±16,897 olarak saptandı. Endoskopik retrograd kolanjiopankreatografi altın standart olarak alındığında ve kanülasyon sağlanamayan hastalar çıkarıldığında koledokolitizis için manyetik rezonans kolanjiopankreatografinin sensitivitesi (%66,6), spesifitesi (%82,8) olarak saptandı. Manyetik rezonans kolanjiopankreatografinin pozitif prediktif değeri (%86,9), negatif prediktif değeri (%59,1) olarak saptandı. 5 mm ve büyük taşlar dikkate alındığında, manyetik rezonans kolanjiopankreatografinin duyarlılığının %91,9’ a çıktığı görüldü. Hepatobiliyer malignitelerde, manyetik rezonans kolanjiopankreatografinin sensitivitesi (%69,56), spesifitesi (%100) olarak saptandı. Manyetik rezonans kolanjiopankreatografinin hepatobiliyer maligniteler için pozitif prediktif değeri (%100), negatif prediktif değeri (%91,13) olarak saptandı. Sonuç: Hepatobiliyer hastalıkların tanısını koymada göstermiş olduğu yüksek sensitivite ve spesifite değerleri nedeni ile manyetik rezonans kolanjiopankreatografi, günümüzde tanı alanında endoskopik retrograd kolanjiopankreatografinin yerini büyük ölçüde almıştır. Teknolojinin gelişmesi ile birlikte daha iyi görüntü kalitesi sonucu tanı alanında bu etkinliğinin daha çok büyümesi beklenmektedir

Anahtar Kelimeler

• Endoskopik retrograd kolanjiopankreatografi
• Manyetik rezonans kolanjiopankreatografi
• Safra yolu taşı

Comparison of the Effectiveness of Endoscopic Retrograde Cholangiopancreatography and Magnetic Resonance Cholangiopancreatography as Diagnostic Imaging Methods in Hepatobiliary Diseases

Öz

Objective: To evaluate the diagnostic effectiveness of magnetic resonance cholangiopancreatography by comparing it with endoscopic retrograde cholangiopancreatography, which is considered the gold standard in diagnosis. Material and Methods: The results of patients who applied to the celal bayar university hospital gastroenterology clinic between 2012-2014 and who performed magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography were analyzed retrospectively. Results: The study included a total of 110 patients (53 males and 57 females). The mean age of the patients was 63.56 ± 16.897 years. When endoscopıc retrograde cholangiopancreatography was taken as the golden standard and after patients with failed cannulation were excluded, the sensitivity and specificity of magnetic resonance cholangiopancreatography in the diagnosis of choledocholithiasis were determined as 66.6% and 82.8%, respectively. The positive predictive value of magnetic resonance cholangiopancreatography was 86.9% and the negative predictive value was 59.1%. For gallstones ≥ 5 mm, the sensitivity of magnetic resonance cholangiopancreatography increased to 91.9%. For hepatobiliary malignancies, the sensitivity and specificity of magnetic resonance cholangiopancreatography were determined to be 69.56% and 100%, respectively, and the positive predictive value was 100% and negative predictive value was 91.13%. Conclusion: Magnetic resonance cholangiopancreatography is a widely used imaging method in the diagnosis of hepatobiliary system diseases. Although it is very effective in the diagnosis of malignant diseases and bile duct stones larger than 6mm, its diagnostic value decreases in the detection of small bile duct stones

Anahtar Kelimeler

• Endoscopic retrograde cholangiopancreatography
• Gallstone
• Magnetic resonance

Kaynakça

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