A prospective pilot study: Can the biliary tree be visualized in children younger than 3 months on Magnetic Resonance Cholangiopancreatography?

Siles, Pascale; Aschero, A.; Gorincour, Guillaume; Bourlière-Najean, B.; Roquelaure, Bertrand; Delarue, A.; Petit, Philippe

doi:10.1007/s00247-014-2953-9

Cited by 22 publications

(10 citation statements)

References 29 publications

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“…For 8 of our infant patients, we could not detect the main pancreatic duct with MRCP due to small size (<1 mm). Siles’ group [ 25 ] reported 16 MRCP pediatric cases of children younger than 3 months-of-age and they also identified main pancreatic ducts in 2 cases. Fitoz’s group [ 26 ] reported that young age can hinder pancreaticobiliary maljunction identification.…”

Section: Discussionmentioning

confidence: 99%

Factors Interfering with Delineation on MRCP of Pancreaticobiliary Maljunction in Paediatric Patients

et al. 2016

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BackgroundThe aim of this study was to assess factors for delineating the pancreaticobiliary junction in the presence of pediatric congenital choledochal cysts (CCC) using Magnetic resonance cholangiopancreatography (MRCP).MethodsRetrospective review of medical records for 48 patients with CCC was conducted, including demographics, biliary amylase and MRCP findings if available. With univariate and multivariate logistic regression, we measured significant factors affecting pancreaticobiliary maljunction(PBM) diagnoses by MRCP.ResultsOf the subjects enrolled with CCC. Twenty-eight cases had PBM according to MRCP. Univariate analysis confirmed that age, cyst diameter > 30 mm and cysts that descended to the introitus pelvis affected junctional delineation and detection of PBM (P<0.05). Stepwise logistic regression analysis confirmed large cysts in the introitus pelvis predicted pancreaticobiliary junctional delineation in MRCP and these data agreed with the literature. A correlation between cyst diameter and the length of the common channel was found as was cyst diameter and biliary amylase although there were no significant differences between them.ConclusionsAge, cyst diameter >30 mm and descending cysts into the introitus pelvis affected junctional delineation of the pancreatic and bile duct in PBM with MRCP. Large cyst descension into the introitus pelvis was an independent factors affecting PBM detection.

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Section: Discussionmentioning

confidence: 99%

Factors Interfering with Delineation on MRCP of Pancreaticobiliary Maljunction in Paediatric Patients

et al. 2016

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“…ESGE recommend endotherapy as a first-line therapy for CP in children starting at 8 years in the same conditions as in adults [215]. Two recently published large series [216,217] In the setting of neonatal anatomy, and in particular, the minute structures of biliary hypoplasia or atresia (BA), MRCP still appears to have unsatisfactory diagnostic accuracy (70% in a recent series on 190 infants) [219]. As the diagnosis of BA at MRCP is based on the absence of visualization of the extrahepatic bile ducts and a prospective evaluation [220] of normal infants by MRCP visualized extrahepatic bile ducts in 62.5% of the cases, the authors concluded that MRCP led to a high level of false positivity in the setting of neonatal cholestasis.…”

Section: Esge/espghan Recommend That Therapeutic Ercp In Pediatric Pamentioning

confidence: 99%

Paediatric Gastrointestinal Endoscopy

Thomson

Tringali

Dumonceau

et al. 2017

J. pediatr. gastroenterol. nutr.

214

251

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This guideline refers to infants, children, and adolescents ages 0 to 18 years. The areas covered include indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography; and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease has been dealt with in other guidelines and are therefore not mentioned in this guideline. Training and ongoing skill maintenance are to be dealt with in an imminent sister publication to this.

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“…MR cholangiopancreatography (MRCP) should be included in examinations performed to evaluate biliary anomalies, by using volumetric three-dimensional heavily T2-weighted sequences performed with respiratory triggering. Noncontrast MRCP is not diagnostically reliable in this age group to evaluate BA (10). However, increasing awareness of gadolinium deposition in the central nervous system along with Elastography, which is used to assess the stiffness of the liver as a measure of fibrosis, has been recognized as a potentially useful way to distinguish between BA and hepatitis.…”

Section: Cholestatic Diseasementioning

confidence: 99%

Hepatic Imaging in Neonates and Young Infants: State of the Art

et al. 2017

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Neonatal liver disease is an important source of morbidity in the pediatric population. The manifestation of liver disease in young infants may be different than in older patients, and there are a number of diagnoses that are unique to this age group. Familiarity with these entities is important as imaging plays a key role in the diagnostic workup, and prompt diagnosis is necessary to prevent complications. This article reviews the spectrum of liver pathologies that can manifest in the first 6 months of life and is intended to educate the general radiologist who may be faced with interpretation of neonatal liver imaging. Categories of disease that will be reviewed include cholestatic diseases, tumors, vascular anomalies, and acquired diseases. The authors will also review optimization of ultrasonography (US) and magnetic resonance imaging of the liver and present a systematic method for interpretation of neonatal liver US findings in the context of clinical and laboratory findings. RSNA, 2017.

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A prospective pilot study: Can the biliary tree be visualized in children younger than 3 months on Magnetic Resonance Cholangiopancreatography?

Abstract: The complete normal biliary system (extrahepatic bile duct confluence included) is not consistently visualized in infants younger than 3 months old on non-enhanced MRCP. Thus the use of MRCP to exclude a diagnosis of biliary atresia is compromised at optimal time of surgery.

Cited by 22 publications

References 29 publications

Factors Interfering with Delineation on MRCP of Pancreaticobiliary Maljunction in Paediatric Patients

Factors Interfering with Delineation on MRCP of Pancreaticobiliary Maljunction in Paediatric Patients

Paediatric Gastrointestinal Endoscopy

Hepatic Imaging in Neonates and Young Infants: State of the Art

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