Varghese JC, Farrell MA, Courtney G, Osborne H, Murray FE, Lee MJ. A prospective comparison of magnetic resonance cholangiopancreatography with endoscopic retrograde cholangiopancreatography in the evaluation of patients with suspected biliary tract disease. Clin Radiol 1999 Aug;54(8):513-20
The Department of Radiology, Beaumont Hospital and The Royal College of Surgeons in Ireland, Dublin.
AIM: To determine the
diagnostic accuracy of magnetic resonance cholangiopancreatography
(MRCP) compared with direct cholangiography in the detection of
biliary tract disease. PATIENTS AND METHODS: MRCP was performed
in 100 patients in whom direct cholangiographic correlation (ERCP,
n = 98; PTC, n = 9; intraoperative cholangiography, n = 3) was
available for comparison. The MRCP examinations were performed
using a two-dimensional multi-slice, fast spin echo (FSE) technique
and a local surface coil. The diagnoses at direct cholangiography
were choledocholithiasis in 30 patients, benign and malignant
strictures in 28 patients and normal bile ducts in 42 patients.
The nature of the strictures (benign, n = 2; tumour, n = 18; lymphnode
recurrence, n = 3; unknown histology, n = 5) was determined by
one or more of the following procedures: surgery (n = 8), biopsy
(n = 15), cytology (n = 6) and cross-sectional imaging/follow-up
findings (n = 3). RESULTS: MRCP diagnosed choledocholithiasis
with a sensitivity of 93%, specificity of 99% and accuracy of
97 %. It resulted in two false-negative and one false-positive
findings when compared with direct cholangiography. MRCP accurately
diagnosed the presence and level of strictures in all patients.
The overall sensitivity, specificity and accuracy of MRCP in the
detection of bile duct lesions were 97%, 98% and 97%, respectively.
CONCLUSION: MRCP has a high diagnostic accuracy when compared
with direct cholangiography in the detection of bile duct disease.
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