Prospective assessment of magnetic resonance cholangiopancreatography for noninvasive imaging of the biliary tree

Taylor, Andrew; Little, Andrew F.; Hennessy, Oliver; Banting, Simon; Smith, Peter J.; Desmond, Paul

doi:10.1067/mge.2002.120324

Cited by 144 publications

(80 citation statements)

References 34 publications

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“…Our results are comparable to those obtained in the literature for conventional MRC (5-9) and fMRC (17). Particularly, conventional MRC sensitivity has been reported as ranging between 81 and 100%, with specificity between 85 and 100% for choledocholithiasis (6 -8) and sensitivites between 85% and 100% for strictures (8,9).…”

Section: Discussionsupporting

confidence: 87%

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Fayad

Holland

Bergin

et al. 2003

Magnetic Resonance Imaging

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Purpose:To determine the diagnostic performance of functional magnetic resonance cholangiography (fMRC) for the evaluation of anatomic and functional biliary disorders.Materials and Methods: At 1.5 T, 39 MR examinations with conventional MRC and mangafodipir trisodium-enhanced fMRC were retrospectively reviewed by three observers who recorded anatomic (duct dilation, stricture, filling defects) and functional (cholecystitis, obstruction) abnormalities in three modes: MRC alone, fMRC alone, and MRC and fMRC images together (combined-MRC). Performance was determined by comparing findings with each mode to findings of invasive cholangiography (IC) and surgery.Results: Among 75 biliary segments (correlated with IC), the sensitivity/specificity for diagnosing dilation (N ϭ 41) with MRC was 95%/97%; with fMRC, 90%/100%; with combined-MRC, 100%/97%. For stricture (N ϭ 7), the sensitivity/specificity of MRC was 86%/98%; of fMRC, 43%/100%; of combined-MRC, 86%/100%. For filling defects (N ϭ 9), the sensitivity/specificity of MRC was 91%/98%; of fMRC, 82%/ 100%; of combined-MRC, 91%/100%. For diagnosing obstruction (N ϭ 9), the sensitivity/specificity of MRC, fMRC, and combined-MRC were 89%/100%, 100%/100%, and 100%/100%, respectively. For surgically proven cholecystitis (N ϭ 13), positive predictive values for diagnosing acute/ chronic cholecystitis for MRC were 33%/40%; for fMRC, 100%/50%; for combined-MRC, 100%/50%. Conclusion:Although single-shot fast spin echo (SSFSE)-MRC is valuable, the addition of fMRC increased diagnostic performance for functional biliary disorders.

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Section: Discussionsupporting

confidence: 87%

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Fayad

Holland

Bergin

et al. 2003

Magnetic Resonance Imaging

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“…The diagnostic accuracy of MRCP has been reported by several authors with an overall sensitivity of 60.5%-97.0%, specificity of 75.0%-98.0%, positive predictive value of 74.1%-89.0%, and negative predictive value of 74.3%-98.0% [9][10][11] . In the present study, these values were 85.0%, 50.0%, 89.4%, and 40.0%, respectively.…”

Section: Methodsmentioning

confidence: 86%

Comparison of Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography in Pancreaticobiliary Pathologies

Değerli¹,

Yılmaz²,

Gökharman³

et al. 2012

Sakarya Med J

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ÖzetBu çalışmanın amacı pankreatikobilier sistem patolojilerinin tespitinde manyetik rezonans kolanjiopankreatografinin (MRCP) duyarlılığı, tanıya katkısını belirlemek ve endoskopik retrograd kolanjiopankreatografi (ERCP) ile karşılaştırmaktır.ERCP günümüzde pankreatikobilier sisteminin değerlendirilmesi için halen altın standart olarak kabul edilir, ancak MRCP safra yollarının değerlendirilmesinde güvenli ve noninvaziv olması nedeniyle tanısal amaçlı ERCP'ye alternatif olabilir. MRCP'nin klinik kullanıma girmesiyle, son zamanlarda özellikle tanısal amaçlı ERCP incelemeleri sayısında azalma eğilimi görülmüştür. Klinik ve laboratuar bulguları ile obstrüktif safra yolu patolojisi düşünülen ancak ultrasonografi ve/veya bilgisayarlı tomografi bulguları kliniği açıklamada yetersiz kalan 51 hasta üzerinde yapılmıştır. Koledok taşı, koledok dilatasyonu, koledok darlıkları ve IHSY dilatasyonu tanısında MRCP'nin duyarlılık, özgüllük, pozitif prediktif değer ve negatif prediktif değeri değerlendirildi. MRCP'nin tüm safra yolları patolojilerinin değerlendirilmesinde duyarlılık, özgüllük, pozitif ve negatif prediktif değerleri sırasıyla, %85.0, %50.0, %89.4 ve %40.0 idi. MRCP deneyiminin artması ve geniş serili çalışmalarla sonuçlarda ilerleme sağlanacak ve tanısal başarı artacaktır. AbstractThe aim of this study was to determine the sensitivity and diagnostic contribution of magnetic resonance cholangiopancreatography (MRCP) in identifying pancreaticobiliary system pathologies and compare with endoscopic retrograde cholangiopancreatography (ERCP). ERCP is currently considered the gold standard for the evaluation of the pancreaticobiliary system. However, MRCP is a safe, non-invasive diagnostic alternative to ERCP. By the introduction of MRCP into clinical use, there has recently been a tendency of decrease especially in the number of ERCP evaluations performed only for diagnostic purposes. 51 patients were included in the study with clinical and laboratory findings suggestive of obstructive biliary tract pathology, but in whom the ultrasound and/or computerized tomography (CT) findings were inconclusive. Sensitivity, specificity, positive and negative predictive value of MRCP in the diagnosis of common bile duct stone, common bile duct dilatation, common bile duct strictures and intrahepatic bile duct (IHBD) dilatation were assessed. The sensitivity, specificity, and positive and negative predictive values of MRCP for the assessment of all biliary tract pathologies were 85.0%, 50.0%, 89.4%, and 40.0%, respectively. An increase in the experience of the MRCP examination and studies with larger series may provide the improvement in results; thus, an increase in diagnostic success may be established.

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“…It has several advantages over traditional and direct cholangiography, as it is noninvasive, there is no need of sedation, has minimal side effects and can demonstrate ducts both below and above a stricture. Several studies have been conducted to evaluate its role in LT patients with suspected biliary obstruction and in a meta-analysis, which included almost 400 LT-patients, MRCP was found to have a sensitivity of 96%, specificity of 94% with a positive likelihood ratio of 17 and a negative likelihood ratio of 0.04 for diagnosis of biliary obstruction [16][17][18][19] . However, it has limited role if LT was performed along with bilioenteric anastomosis and for diagnosis of malignant strictures [16,20] .…”

Section: Diagnosis and Evaluation Of Btc After Ltmentioning

confidence: 99%

Endoscopic management of post-liver transplant biliary complications

Girotra¹,

Soota²,

Klair³

et al. 2015

WJGE

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Biliary complications are being increasingly encountered in post liver transplant patients because of increased volume of transplants and longer survival of these recipients. Overall management of these complications may be challenging, but with advances in endoscopic techniques, majority of such patients are being dealt with by endoscopists rather than the surgeons. Our review article discusses the recent advances in endoscopic tools and techniques that have proved endoscopic retrograde cholangiography with various interventions, like sphincterotomy, bile duct dilatation, and stent placement, to be the mainstay for management of most of these complications. We also discuss the management dilemmas in patients with surgically altered anatomy, where accessing the bile duct is challenging, and the recent strides towards making this prospect a reality. Core tip: Biliary complications are being increasingly encountered in post liver transplant patients because of increased volume of transplants and longer survival of these recipients. Overall management of these complications may be challenging, but with advances in endoscopic techniques, majority of such patients are being dealt with by endoscopists rather than the surgeons. Our review article discusses the recent advances in endoscopic tools and techniques which have proved ERCP with various interventions, like sphincterotomy, bile duct dilatation, and stent placement, to be the mainstay for management of most of these complications. We also deliberate the management dilemmas in patients with surgically altered anatomy, where accessing the bile duct is challenging, and the recent strides towards making this prospect a reality.

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Prospective assessment of magnetic resonance cholangiopancreatography for noninvasive imaging of the biliary tree

Cited by 144 publications

References 34 publications

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Comparison of Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography in Pancreaticobiliary Pathologies

Endoscopic management of post-liver transplant biliary complications

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