OBJECTIVE: The aim of this retrospective
study was to clarify whether MR cholangiopancreatography (MRCP) is a suitable
replacement for ERCP in evaluation of the choledochal cyst. MATERIALS AND
METHODS: Sixteen patients (six adult and 10 pediatric) with choledochal
cysts underwent MRCP using a half-Fourier acquisition single-shot turbo
spin-echo sequence. Extent of the cyst, defects within the biliary tree,
and presence or absence of the anomalous junction of the pancreaticobiliary
duct were evaluated. Findings were compared with those of ERCP. RESULTS:
MRCP better defined the proximal biliary tree than did ERCP in two patients.
Defects within the biliary tree were diagnosed correctly on MRCP in eight
patients; however, two defects within the distal common bile duct were
missed in pediatric patients. The presence of the anomalous junction of
the pancreaticobiliary duct was revealed accurately by MRCP in all adult
patients but was revealed accurately in only four of the 10 pediatric patients.
CONCLUSION: MRCP appears to offer diagnostic information that is equivalent
to that of ERCP for assessment of choledochal cysts in adults. In pediatric
patients, MRCP should not replace ERCP; however, MRCP can play an important
role as a noninvasive examination and should be considered a first-choice
imaging technique for evaluation of choledochal cysts.
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