Neoplastic pancreaticobiliary duct obstruction: Evaluation with breath-hold MR cholangiopancreatography Journal Article
| Authors: | Schwartz, L. H.; Coakley, F. V.; Sun, Y.; Blumgart, L. H.; Fong, Y.; Panicek, D. M. |
| Article Title: | Neoplastic pancreaticobiliary duct obstruction: Evaluation with breath-hold MR cholangiopancreatography |
| Abstract: | OBJECTIVE. The purpose of this study was to investigate the use of breath-hold single-shot fast spin-echo MR cholangiopancreatography in neoplastic pancreaticobiliary duct obstruction. MATERIALS AND METHODS. Breath-hold MR cholangiopancreatography was performed for preoperative examination of 32 consecutive patients with pathologically confirmed neoplastic obstruction of the biliary tract or pancreatic duct using a single-shot fast spin-echo sequence. Two observers, unaware of clinical or pathologic findings, independently reviewed the MR cholangiopancreatograms to assess level of obstruction and site of underlying tumor. Pathologic diagnoses, based on surgical or CT-guided biopsy specimens, were pancreatic tumor (n = 12), gallbladder cancer (n = 9), intrahepatic cancer (n = 9), and ampullary cancer (n = 2). RESULTS. On the basis of conventional cholangiography, CT, and surgical findings, 20 patients had isolated bile duct obstruction, 11 patients had combined pancreatic and bile duct obstruction, and one patient had isolated pancreatic duct obstruction. Isolated bile duct obstruction was classified as lobar (n = 5), hilar (n = 12), or distal (n = 3). These levels of obstruction were correctly identified in 27 (84%) and 28 (88%) of the 32 cases by the two observers. The site of the underlying tumor was identified in 27 (84%) and 29 (91%) cases by the two observers. Good interobserver agreement was reached for both level of obstruction (κ = .70) and identification of tumor site (κ = .75). CONCLUSION. Breath-hold single-shot fast spin-echo MR cholangiopancreatography is accurate in identifying the level of obstruction and the site of underlying tumor in neoplastic pancreaticobiliary duct obstruction, with good interobserver agreement. |
| Keywords: | adult; clinical article; human tissue; aged; aged, 80 and over; middle aged; liver neoplasms; pancreatic neoplasms; nuclear magnetic resonance imaging; magnetic resonance imaging; diagnostic accuracy; preoperative evaluation; tumor localization; computer assisted tomography; observer variation; biopsy; pancreas tumor; pancreatic ducts; liver cancer; bile duct obstruction; gallbladder neoplasms; breath holding; gallbladder cancer; cholestasis; endoscopic retrograde cholangiopancreatography; vater papilla carcinoma; ampulla of vater; common bile duct neoplasms; pancreas duct stenosis; pancreatic diseases; constriction, pathologic; humans; human; male; female; priority journal; article |
| Journal Title: | American Journal of Roentgenology |
| Volume: | 170 |
| Issue: | 6 |
| ISSN: | 0361-803X |
| Publisher: | American Roentgen Ray Society |
| Date Published: | 1998-06-01 |
| Start Page: | 1491 |
| End Page: | 1495 |
| Language: | English |
| PUBMED: | 9609160 |
| PROVIDER: | scopus |
| DOI: | 10.2214/ajr.170.6.9609160 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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