No abstract

No abstract

OBJECTIVE. The aim of thisretrospective studywasto clarify whetherMR cholangiopan creatography (MRCP) isa suitablereplacement for ERCP in evaluation of thecholedochal cyst. MATERIALSAND METHODS. Sixteenpatients(six adultand 10pediatric)with chole dochal cysts underwent MRCP using a half-Fourier acquisition single-shot turbo spin-echo se quence. 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 betterdefinedthe proximalbiliary tree thandid ERCP in two patients. Defectswithin the biliary tree were diagnosedcorrectlyon 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 appearsto offer diagnosticinformationthat is equivalentto that of ERCP for assessment ofcholedochalcystsin adults.In pediatricpatients, MRCP shouldnot replace ERCP; however, MRCP can play an important role as a noninvasive examination and shouldbe considered a first-choiceimagingtechniquefor evaluationof choledochal cysts.

With the use of the more intensive induction regimen A plus blood stem cell transplantation for MYCN-amplified patients, survival curves for those with or without MYCN amplification now appear similar. Higher doses of chemotherapy may ameliorate the effect of MYCN amplification in patients with high-risk neuroblastoma.