Contribution of magnetic resonans cholangiopancretography to the diagnosis in the phenomenons of biliary obstruction pre-diagnosis

Yıl 2012, Cilt: 3 Sayı: 2, 59 - 64, 22.10.2012

Zeyneb Değerli Ömer Yılmaz , Fatma Gökharman Uğur Koşar

Öz

Objective: The aim of our study was to evaluate the contribution of magnetic resonance cholangiopancretography to the diagnosis of pancreoticobiliary system pathologies in patients who had clinical and/or laboratory findings of biliary obstruction. Material–Method: One hundred and ninety eight cases were added to the study. The cases that were thought to have obstructive biliary tract pathology but incongruous with the findings of ultrasonography and/or computerized tomography were evaluated by using magnetic resonance cholangiopancreatography. Investigation was progressed with 1.5 Tesla MR appliance and (Signa HDI, General Electric, 1Milwaukee, WI, USA), HD 8 splined body array. For statistical analysis SPSS (Statistical Package for Social Sciences) for  Windows 16.0 program was used. Results: One hundred and twenty eight percent of the cases were women (64,6%), 70 % of them were men. Sixty nine out of 198 patients were operated of gall bladder. Seven patients could not be assessed by magnetic resonance cholangiopancreatography. In 43 patients, gallstone was found in saccus. Three patients who have contracted gall blader saccus lumen could not be evaluated in terms of gallstone. In 30 cases (15.2%) choledocholithiasis were detected. In 4 cases (2%) choledocta stent was detected. In 5 patients 2.5(%) structural scantiness was present . In 5 cases (2.5%) inner lumen filling defect in favour of air was reclaimed. Discussion: Magnetic resonance cholangiopancreatography is a diagnostic method which has a potential to substitute endoscopic retrograde cholangiopancreatography. Because it is a non–invasive method, it has a wider usage area currently. With increasing experience and the chance of investigation wider series of patients, evaluations with magnetic resonance cholangiopancreatography will be progressed and diagnostic success rate will increase.

Anahtar Kelimeler

Biliary obstruction, Magnetic resonance cholangiopancreatography, Endoscopic retrograde cholangiopancreatography

Biliyer obstrüksiyon ön tanısı ile başvuran olgularda manyetik rezonans kolanjiopankreotografi bulgularının tanıya olan katkısı

Öz

Amaç: Çalışmamızın amacı biliyer obstrüksiyon klinik ve/veya laboratuar bulguları ile gönderilen hastaların pankreotikobilier sistem patolojilerinin tespitinde manyetik rezonans kolanjiopankreotografi'nin tanıya katkısını değerlendirmektir.
Gereç Yöntem: Çalışmaya 198 olgu dahil edildi. Obstrüktif safra yolu patolojisi düşünülen ancak ultrasonografi ve/veya bilgisayarlı tomografi bulguları uyumsuz olan olgular manyetik rezonans kolanjiopankreotografi ile değerlendirildi. İnceleme 1.5 Tesla MR cihazı ile (Signa HDI, General Electric, 1Milwaukee, WI, USA), HD 8 kanallı body array coil'i kullanılarak yapıldı. İstatiksel analizler için SPSS (Statistical Package for Social Sciences) for Windows 16.0 programı kullanıldı.
Bulgular: Olguların 128'i (%64,6) kadın, 70'i (%35,4) erkekdi. 198 hastanın 69'unda safra kesesi opere edilmişdi. 7 hastada safra kesesi manyetik rezonans kolanjiopankreotografi ile değerlendirilemedi. 43 hastada kesede taş izlendi. Safra kesesi kontrakte olan 3 hastada kese lümeni taş açısından değerlendirilemedi. 30 (%15,2) olguda koledokolitiazis saptandı. 4 (%2) olguda koledokta stent izlendi. 5 (%2,5) hastada striktürel darlık mevcuttu. 5 (%2,5) olguda ise lümen içi dolum defekti hava lehine değerlendirildi.
Sonuç: Manyetik rezonans kolanjiopankreotografi, tanısal endoskopik retrograd kolanjiopankreotografi'nin yerine geçme potansiyeline sahip bir inceleme yöntemidir. Non-invaziv bir yöntem olması nedeniyle günümüzde giderek daha geniş bir kullanım alanı kazanmaktadır. Deneyimin artması ve daha geniş serilerle çalışma imkanı ile manyetik rezonans kolanjiopankreotografi değerlendirmesinde ilerleme sağlanacak böylece tanısal başarı artacaktır. 

Anahtar Kelimeler

Biliyer obstrüksiyon, Manyetik rezonans kolanjiopankreotografi, Endoskopik retrograd kolanjiopankreotografi

Kaynakça

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