Breath-hold MR cholangiography with snapshot techniques: prospective comparison with endoscopic retrograde cholangiography.

Abstract

Snapshot MR cholangiography allowed noninvasive, accurate detection of biliary stones, strictures, and dilatation similar to that with ERC. Discrepancies regarding low-grade dilatation and strictures had no clinical relevance at retrospective review.

Common bile duct stones — their presentation, diagnosis and management

“…This relatively new diagnostic procedure which involves capturing a heavily T2 weighted image (which enhances fl uid containing structures) is rapidly gaining acceptance [12][13][14][15][16][17][18][19][20][21][22][23]. The reasons for this are (i) It is non-invasive (ii) It simultaneously gives considerable information regarding adjacent structures such as the pancreas and liver (iii) Allows for 3 dimensional reconstruction (iv) Combined with Gadolinium enhanced MR angiography forms a complete single investigation (v) Can replace intraoperative cholangiogram once experience at interpretation improves (vi) Shares the same disadvantages as ERCP in that it cannot differentiate between stone, sludge, mucus plugs…”

“…Pitfalls were caused by fl ow artifacts, compression by vessels, and low contrast between calculi and surrounding parenchyma [17]. The sensitivity for detecting stones appears to decrease according to the size of the stone: 67-100% for stones >10 mm in size, 89-94% for stones measuring 6-10 mm, and 33-71% for bile duct stones <6 mm in size [47].…”

“…Choledocholithiasis can be diagnosed with a sensitivity of 88-92% and specifi city of 91-98% (vs. 98% for ERCP) [12][13][14][15][16][17][18][19][20][21][22][23]. In a blinded study with 110 patients, 30 with choledocholithiasis, 2 observers, one of whom had an experience of 2 years, achieved comparable results with a sensitivity of 90%, specifi city of 93%, positive predictive value of 82%, and negative predictive value of 96% and overall accuracy of 92% with inter-observer agreement of 93% [21].…”

Estudo comparativo entre a colangiopancreatografia por ressonância magnética e a colangiopancreatografia endoscópica no diagnóstico das obstruções biliopancreáticas

“…A CPRM teve sensibilidade de 89% e especificidade de 67%. Os achados mostram valores próximos de sensibilidade aos descritos na literatura em análise de grandes séries, variando de 85% a 100% (1,2,4,6,9,11,14,16,20,26,28) . Entretanto, os valores de especificidade observados no presente estudo, discordam dos apresentados por outros autores.…”

The Qualitative Analysis of Single Shot Fast Spin Echo (SSFSE) and Maximum Intensity Projection (MIP) on Magnetic Resonance Cholangiopancreatography

“…In regard to previous MRI images of the liver and biliary system, the image quality is low, the test takes a long time, breathing must be held for a long time during the test, and it is difficult to acquire satisfactory images. Recently, images could be acquired within a short time with the application of a single shot fast spin echo (SSFSE) [5,6]. On the other hand, in previous MRCP, it was difficult to assess simultaneously the presence or absence of stenosis of the pancreatobiliary system, and whether the biliary duct is dilated or not, etc..…”