A prospective evaluation of magnetic resonance cholangiopancreatography in patients with suspected bile duct obstruction

Abstract

Background-The value of magnetic resonance cholangiopancreatography (MRCP) is under debate. Aims-To assess the diagnostic accuracy of MRCP and endoscopic retrograde cholangiopancreatography (ERCP) and to determine whether MRCP may help to prevent unnecessary interventional procedures. Methods-Eighty six patients with suspected common bile duct obstruction who presented between January and December 1996 were enrolled. Twenty six were excluded due to anatomical reasons or because MRCP or ERCP could not be performed successfully. Results of MRCP were interpreted by two radiologists and a gastroenterologist unaware of clinical diagnosis. Final diagnosis was determined by ERCP and histopathological findings or a follow up of at least 12 months. Results-MRCP images of diagnostic quality were obtained in all 60 patients. Thirteen patients had a clear bile duct. Sensitivity and specificity for the detection of any abnormality (n=47) were 89% and 92%, and for the detection of malignancy (n=27) 81% and 100%, respectively. These results were equivalent to the respective figures of ERCP (91% and 92% for any abnormality, and 93% and 94% for malignant diseases). Conclusions-MRCP is as sensitive as ERCP in the evaluation of bilary tract diseases. As the specificity of this noninvasive technique is close to 100%, MRCP may prevent inappropriate invasive explorations of the common bile duct and pancreatic duct. (Gut 1998;43:680-683)

Biliary Complications After Liver Transplantation: Old Problems and New Challenges

“…However, a prospective study of MRCP and ERC revealed comparable sensitivities for detection of biliary obstruction (13). Other studies confirmed a ≥90% sensitivity and specificity and positive and negative predictive values of 90% for MRCP (14,15).…”

A systematic review and economic evaluation of magnetic resonance cholangiopancreatography compared with diagnostic endoscopic retrograde cholangiopancreatography

“…49 Of the 28 studies, one reported a non-consecutive sample 77 and in 13 studies the method of sample selection was not reported. 21,[55][56][57]59,61,62,64,68,69,71,74,75 Barish and colleagues 58 and Soto and colleagues 73 report random selection of referrals, and Macaulay and colleagues 70 a sequential sample selection, although it is not clear whether or not the sequence was consecutive. Therefore, only 13 studies used appropriate methods of sample selection.…”

“…Six other studies reported some failed MRCP or MRCP not of diagnostic quality .6,58,72,74,78,79 Claustrophobia in patients associated with MRCP was reported in ten studies. 55,57,61,63,64,69,71,72,75,78 One study reported that one patient was unable to undergo MRCP owing to obesity. 69 Failed ERCP procedures were reported in 12 studies, with no indication as to whether or not subsequent investigations were attempted.…”

Routine magnetic resonance cholangiopancreatography and intra-operative cholangiogram in the evaluation of common bile duct stones

“…MRCP has been shown to be sensitive and specific in the evaluation of choledocholithiasis when compared to ERCP. [3][4][5][6] It is generally well tolerated 7 and avoids the potential complications of ERCP when used as a diagnostic modality. It has high sensitivity and specificity in the initial evaluation of patients with clinical obstructive jaundice and could replace the direct cholangiography when is used for diagnostic purpose.…”