Comparison of Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography in Pancreaticobiliary Pathologies

Yıl 2012, , 174 - 180, 01.12.2012

Zeyneb Büyük Değerli Ömer Yılmaz Fatma Dilek Gökharman Uğur Koşar

https://doi.org/10.5505/sakaryamj.2012.68552

Cited By: 1

Öz

The aim of this study was to determine the sensitivity and diagnostic contribution of magnetic resonance cholangiopancreatography (MRCP) in identifying pancreaticobiliary system pathologies and compare with endoscopic retrograde cholangiopancreatography (ERCP).ERCP is currently considered the gold standard for the evaluation of the pancreaticobiliary system. However, MRCP is a safe, non-invasive diagnostic alternative to ERCP. By the introduction of MRCP into clinical use, there has recently been a tendency of decrease especially in the number of ERCP evaluations performed only for diagnostic purposes.51 patients were included in the study with clinical and laboratory findings suggestive of obstructive biliary tract pathology, but in whom the ultrasound and/or computerized tomography (CT) findings were inconclusive.Sensitivity, specificity, positive and negative predictive value of MRCP in the diagnosis of common bile duct stone, common bile duct dilatation, common bile duct strictures and intrahepatic bile duct (IHBD) dilatation were assessed. The sensitivity, specificity, and positive and negative predictive values of MRCP for the assessment of all biliary tract pathologies were 85.0%, 50.0%, 89.4%, and 40.0%, respectively.An increase in the experience of the MRCP examination and studies with larger series may provide the improvement in results; thus, an increase in diagnostic success may be established.

Anahtar Kelimeler

MRCP, ERCP, biliary tract pathologies

Pankreatikobilier Patolojilerde Manyetik Rezonans Kolanjiopankreatografi ile Endoskopik Retrograd Kolanjiopankreatografinin Karşılaştırılması

Öz

Bu çalışmanın amacı pankreatikobilier sistem patolojilerinin tespitinde manyetik rezonans kolanjiopankreatografinin (MRCP) duyarlılığı, tanıya katkısını belirlemek ve endoskopik retrograd kolanjiopankreatografi (ERCP) ile karşılaştırmaktır.ERCP günümüzde pankreatikobilier sisteminin değerlendirilmesi için halen altın standart olarak kabul edilir, ancak MRCP safra yollarının değerlendirilmesinde güvenli ve noninvaziv olması nedeniyle tanısal amaçlı ERCP'ye alternatif olabilir. MRCP'nin klinik kullanıma girmesiyle, son zamanlarda özellikle tanısal amaçlı ERCP incelemeleri sayısında azalma eğilimi görülmüştür.Klinik ve laboratuar bulguları ile obstrüktif safra yolu patolojisi düşünülen ancak ultrasonografi ve/veya bilgisayarlı tomografi bulguları kliniği açıklamada yetersiz kalan 51 hasta üzerinde yapılmıştır. Koledok taşı, koledok dilatasyonu, koledok darlıkları ve IHSY dilatasyonu tanısında MRCP'nin duyarlılık, özgüllük, pozitif prediktif değer ve negatif prediktif değeri değerlendirildi. MRCP'nin tüm safra yolları patolojilerinin değerlendirilmesinde duyarlılık, özgüllük, pozitif ve negatif prediktif değerleri sırasıyla, %85.0, %50.0, %89.4 ve %40.0 idi.MRCP deneyiminin artması ve geniş serili çalışmalarla sonuçlarda ilerleme sağlanacak ve tanısal başarı artacaktır.

Anahtar Kelimeler

MRCP, ERCP, safra yolu patolojileri

Kaynakça

• Bilbao MK, Dotter CT; Lee TG, et al. Complications of ERCP; a study of 10 000 cases. Gastoenterology 1976; 70; 314-320.
• Calvo MM, Bujanda L, Calderon A et al. Role of magnetic reso- nance cholangiopancreatography in patients with suspected choledocholitiasis. Mayo Clin Proc 2002; 77: 422–8.
• Manfredi R, Brizzi MG, Masselli G et al. Malignant biliary hilar stenosis: MR cholangiography compared with direct cholangio- graphy. Radiol Med, 2001; 102: 48–54
• Pavone P, Laghi A, Catalano C et al. MRI of the biliary and pancre- atic ducts. Eur Radiol, 1999; 9: 1513–22.
• Laing AD, Gibson RN. Magnetic resonance cholangiopancreatog- raphy. Australas Radiol, 1999; 43: 284–93.
• Little AF, Smith PJ, Lee WK, Hennessy OF, Desmond PV, Bant- ing SW, et al. Imaging of the normal and abnormal pancreatico- biliary system with single-shot MR cholangiopancreatography: a pictorial review. Australas Radiol 1999;/43:/427_34.
• Lincender L, Sadagic E, Vrcic D et al. Magnetic resonance chol- angiography in patients with bile duct obstruction. Radiol Oncol, 2000; 34: 319–24.
• Barish MA, Yucel EK, Ferrucci JT. Magnetic resonance cholangio- pancreatography. N Engl J Med, 1999; 341: 258–64
• Soto JA, Barish MA, Yucel EK, Siegenberg D, Ferrucci JT, Chut- tani R. Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography. Gastroenterol- ogy 1996; 110: 589–97.
• Varghese JC, Farrell MA, Courtney G, et al. A prospective com- parison of magnetic resonance cholangiopancreatography with endoscopic retrograde cholangiopancreatography in the evalua- tion of patients with suspected biliary tract disease. Clin Radiol 1999; 54: 513-520.
• Taylor ACF, Little AF. Prospective assessment of MRCP for non- invasive imaging of the biliary tree. Gastrointest Endosc 2002; 55(1): 17-22.
• Romagnuolo J, Bardou M, Rahme E, et al. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med 2003; 139: 547-557.
• Kaltenthaler E, Bravo Vergel Y, Chilcott J, et al. A systematic review and economic evaluation of magnetic resonance cholan- giopancreatography compared with diagnostic endoscopic ret- rograde cholangiopancreatography. Executive summary. Health Technology Assessment 2004; 8(10): 1-6.
• Hurter D, Vries CD, Potgieter PH, Barry R, Botha F J H, Joubert G. Accuracy of MRCP compared with ERCP in the diagnosis of bile duct disorders SA Journal Of Radiology 2008; 14-22.
• Moon JH, Cho YD, Cha SW, et al. The detection of bile duct stones in suspected biliary pancreatitis: Comparison of MRCP, ERCP, and intraductal US. Am J Gastroenterol 2005; 100: 1051- 1057.
• Laokpessi A, Bouillet P, Sautereau D, Cessot F, Desport J-C, Sidaner A, Pillegand B. Value of magnetic resonance cholangio- graphy in the preoperative diagnosis of common bile duct stones. Am J Gastroenterol 2001; 96:2354–2359.
• Hauer-Jensen M, Karesen R, Nygaard K, Solheim K, Amlie E, Havig O, Viddal KO. Consequences of routine perioperative chol- angiography during cholecystectomy for gallstone disease – a prospective randomized study. World J Surg 1986; 10:996–1002.
• Murison MSC, Gartell PC, McGinn FP. Does selective preopera- tive cholangiography result in missed common bile duct stones? [Abstract]. Br J Surg 1989; 76:1343.
• Fulcher AS, Turner MA. Pitfalls of MR cholangiopancreatography. J Comput Assist Tomogr 1998; 22:845–850.