A Retrospective Assessment of Magnetic Resonance Cholangiopancreatography in Children

Tipnis, Neelesh A.; Dua, Kulwinder S.; Werlin, Steven L.

doi:10.1097/01.mpg.0000304455.76928.0e

Cited by 42 publications

(15 citation statements)

References 27 publications

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“…Studies were included that had a minimum of 5 patients in whom MRCP was used as a diagnostic tool and findings were compared to ERCP or surgery. Smaller case series were excluded, as is consistent with previously published peer-reviewed data [23,24] . This study was approved by the local institutional review board.…”

Section: Literature Review Criteriamentioning

confidence: 70%

Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

Sacher

Davis²,

Sleeman³

et al. 2013

WJR

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AIM:To determine the merits of magnetic resonance cholangiopancreatography (MRCP) as the primary diagnostic test for choledochal cysts (CC's). METHODS:Between 2009 and 2012, patients who underwent MRCP for perioperative diagnosis were identified. Demographic information, clinical characteristics, and radiographic findings were recorded. MRCP results were compared with intraoperative findings. A PubMed search identified studies published between 1996-2012, employing MRCP as the primary preoperative imaging and comparing results with either endoscopic retrograde cholangiopancreatography (ERCP) or operative findings. Detection rates for CC's and abnormal pancreaticobiliary junction (APBJ) were calculated. In addition detection rates for clinically related biliary pathology like choledocholithiasis and cholangiocarcinomas in patients diagnosed with CC's were also evaluated. RESULTS:Eight patients were identified with CC's. Six patients out of them had type Ⅳ CC's, 1 had type I and 1 had a new variant of choledochal cyst with confluent dilatation of the common bile duct (CBD) and cystic duct. Seven patients had an APBJ and 3 of those had a long common-channel. Gallstones were found in 2 patients, 1 had a CBD stone, and 1 pancreatic-duct stone was also detected. In all cases, MRCP successfully identified the type of CC's, as well as APBJ with ductal stones. From analyzing the literature, we found that MRCP has 96%-100% detection rate for CC's. Additionally, we found that the range for sensitivity, specificity, and diagnostic accuracy was 53%-100%, 90%-100% and 56%-100% in diagnosing APBJ. MRCP's detection rate was 100% for choledocholithiasis and 87% for cholangiocarcinomas with concurrent CC's. CONCLUSION:After initial ultrasound and computed tomography scan, MRCP should be the next diagnostic test in both adult and pediatric patients. ERCP should be reserved for patients where therapeutic intervention is needed.© 2013 Baishideng. All rights reserved.Key words: Magnetic resonance cholangiopancreatography; Choledochal cyst; Abnormal pancreaticobiliary junction; Diagnostic test; Choledocholithiasis; Cholangiocarcinomas Core tip: Magnetic resonance cholangiopancreatography (MRCP) is used as primary diagnostic approach in various biliary pathologies. This is the first literature review of published studies discussing MRCP as a diagnostic modality for choledochal cysts. This review further outlines how recent imaging techniques have improved diagnostic accuracy of MRCP in diagnosing choledochal cysts and their associated anatomic variants. Advantages, disadvantages and contraindication for MRCP with respect to endoscopic retrograde cholangiopancreatography are also discussed.

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Section: Literature Review Criteriamentioning

confidence: 70%

Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

Sacher

Davis²,

Sleeman³

et al. 2013

WJR

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“…3D reconstructions (maximum intensity projection) images are easily obtained, although sedation may be required in infants and small children. Breath-hold sequences and respiratory triggered scanning can eliminate background signal and increase the hyperintense fluid signal in the bile duct 22 23. Functional assessment of the CM may be shown using a dynamic radio-isotope scan which can show baseline parenchymal hepatocyte uptake together with the pattern and degree of bile excretion—important if not considering surgery.…”

Section: Diagnostic Issuesmentioning

confidence: 99%

Understanding choledochal malformation

Makin

Davenport

2011

Arch Dis Child

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Choledochal malformations (also known as choledochal cysts) may be characterised as an abnormal dilatation of the biliary tract, in the absence of any acute obstruction. Most appear to be of congenital origin probably related to distal bile duct stenosis, and almost 15% can now be detected antenatally. Excision and biliary reconstruction using a Roux loop as an open operation is still the standard to compare to. This article discusses recent advances in the understanding of their aetiology and classification together with the place of newer modalites of surgical treatment such as laparoscopic excision and biliary reconstruction. Although these are definitely feasible and safe, care should be taken before dispensing with standard open techniques which have minimal complications and proven long-term benefit.

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“…MRCP is an appropriate method of diagnostic modality of the biliary system in children and should be the first choice of imaging for pancreaticobiliary system in children 64,68 .…”

Section: Ap-iv6 When Should Mrcp Be Performed In Pediatric Ap?mentioning

confidence: 99%

EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis

et al. 2018

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A Retrospective Assessment of Magnetic Resonance Cholangiopancreatography in Children

Abstract: In this retrospective study, MRCP was sensitive and specific in identifying anatomic abnormalities of the pancreatobiliary tree in children. MRCP should be considered before direct CP to evaluate anatomic abnormalities of the pancreatobiliary tree.

Cited by 42 publications

References 27 publications

Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

Understanding choledochal malformation

EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis

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