Comparison of magnetic resonance and endoscopic retrograde cholangiopancreatography in malignant pancreaticobiliary obstruction Journal Article
| Authors: | Georgopoulos, S. K.; Schwartz, L. H.; Jarnagin, W. R.; Gerdes, H.; Breite, I.; Fong, Y.; Blumgart, L. H.; Kurtz, R. C. |
| Article Title: | Comparison of magnetic resonance and endoscopic retrograde cholangiopancreatography in malignant pancreaticobiliary obstruction |
| Abstract: | Hypothesis: We hypothesize that magnetic resonance cholangiopancreatography (MRCP) is comparable to endoscopic retrograde cholangiopancreatographic (ERCP) as a diagnostic tool in patients with malignant biliary obstruction. Design: Eighteen patients with suspected pancreaticobiliary malignancy were evaluated by ERCP and MRCP in 8 months (March 1, 1996, to October 31, 1996). Magnetic resonance cholangiopancreatography was performed with a 1.5-T scanner using 4-mm slices. Images were obtained in a 14- to 28-second breath-hold. Images from MRCP were retrospectively evaluated by a radiologist for image quality, ductal dilation, level of obstruction, and overall diagnostic impression. Images from ERCP were retrospectively evaluated by a biliary endoscopist (L.H.S.) and served as the standard for calculating sensitivity, specificity, and positive predictive values. In addition, intraoperative findings were compared with MRCP results in all patients explored. Results: Diagnostic- quality MR images were obtained in 18 patients (100%). Diagnostic-quality endoscopic images were obtained in 16 (89%) of 18 attempted biliary cannulations and 11 (78%) of 14 attempted pancreatic cannulations. Magnetic resonance CP accurately delineated the level of extrahepatic biliary ductal obstruction in 13 (87%) of 15 patients. More important, MRCP provided valuable staging information in most patients. Findings from MRCP correlated with operative findings (size and location of tumor and mesenteric vascular involvement) in 8 (80%) of 10 patients who underwent surgery, while failing in 2 patients (20%) with carcinomatosis. Conclusions: Magnetic resonance CP is a sensitive study for detecting the presence and level of biliary ductal obstruction in patients with cancer. The results are comparable to those of ERCP; however, MRCP provides additional data regarding extent of disease that is not available from ERCP alone. |
| Keywords: | adult; clinical article; aged; middle aged; retrospective studies; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer diagnosis; diagnostic imaging; pancreas carcinoma; image quality; pancreatic ducts; intermethod comparison; bile duct carcinoma; bile duct obstruction; cholestasis; endoscopic retrograde cholangiopancreatography; cholangiopancreatography, endoscopic retrograde; humans; human; male; female; priority journal; article; duodenoscopy |
| Journal Title: | Archives of Surgery |
| Volume: | 134 |
| Issue: | 9 |
| ISSN: | 0004-0010 |
| Publisher: | American Medical Association |
| Date Published: | 1999-09-01 |
| Start Page: | 1002 |
| End Page: | 1007 |
| Language: | English |
| DOI: | 10.1001/archsurg.134.9.1002 |
| PUBMED: | 10487597 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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