Extrahepatic Biliary Obstruction: Magnetic Resonance  Imaging Compared With Endoscopic Ultrasonography

Materne, R; Beers, Bernard E. Van; Gigot, Jean‐François; Jamart, J; Geubel, André; Pringot, Jacques; Deprez, Pierre Henri

doi:10.1055/s-2000-86

Cited by 107 publications

(69 citation statements)

References 30 publications

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“…The ampulla of Vater is a possible blind spot for MRI because of its small size and the tapering of the intramural ducts containing little fluid. 10,23 Although not statistically significant in our study, EUS had a higher accuracy compared with MRI in the detection and T staging of ampullary tumors. Moreover, only 16 subjects underwent MRI because it was not available in our hospital until 2002.…”

Section: Discussionmentioning

confidence: 64%

“…Some ampullary carcinomas are covered by intact epithelium, and the accuracy of biopsies is reportedly lower in the tumors with intra-ampullary growth compared with tumors with extraampullary growth or ulceration. 10,14,15 We found that the preoperative diagnosis of moderate or severe dysplasia on biopsy should be viewed as suspicion for carcinoma. EST had some limitations, including the interference with EUS staging and histologic examination due to tissue destruction, and possible complications such as hemorrhage, perforation, or pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

“…20 Consistent with the literature, we showed that US easily demonstrates CBD dilatation (n 5 41) but rarely visualizes the tumor itself (n 5 5). 8,10 Nonetheless, US remains the initial modality of diagnostic images in approaching pancreatobiliary lesions due to its convenience, low cost, and noninvasiveness. CT can miss small tumors or tumors in patients who have a very small amount of fat, such as cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…For preoperative evaluation of ampullary tumors, EUS is more accurate than transabdominal sonography (US) or CT. 2,7,8 Despite the relative advantages of EUS, MRI, including magnetic resonance cholangiopancreatography, continues to be regarded as the most reliable noninvasive diagnostic imaging modality for the evaluation of pancreatobiliary lesions. 9,10 This retrospective study evaluated the accuracy of US, CT, MRI, and EUS in the preoperative staging of ampullary tumors. The study also examined the influence of transpapillary stenting and tumor characteristics such as tumor extension, size, differentiation, and macroscopic appearance of tumor at endoscopy on the staging accuracy of EUS.…”

mentioning

confidence: 99%

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Reappraisal of endosonography of ampullary tumors: Correlation with transabdominal sonography, CT, and MRI

Chen

Yang

Yeh

et al. 2008

J of Clinical Ultrasound

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Purpose. To reappraise the accuracy of transabdominal sonography (US), CT, MRI, and endosonography (EUS) in the diagnosis and staging of ampullary tumors.Method. We reviewed the medical records and the images of 41 consecutive patients with ampullary tumors. Tumor detection rate and accuracy of TNM (tumor-node-metastasis) staging of malignant tumors were determined. Imaging findings were correlated with histopathologic findings.Results. The detection rates for ampullary tumors were 97.6% for EUS, 81.3% for MRI, 28.6% for CT, and 12.2% for US (p < 0.001 for EUS versus CT; p < 0.001 for EUS versus US; p > 0.05 for EUS versus MRI). The accuracy in T staging for ampullary carcinomas was 72.7% for EUS, 53.8% for MRI, and 26.1% for CT (p < 0.01 for EUS versus CT; p > 0.05 for EUS versus MRI). The accuracy in N staging for ampullary carcinomas was 66.7% for EUS, 76.9% for MRI, and 43.5% for CT with no statistically significant difference between the 3 modalities. The sensitivity in detecting malignant lymph nodes was 46.7% for EUS, 25.0% for MRI, and 0% for CT (p < 0.01 for EUS versus CT; p > 0.05 for EUS versus MRI; p > 0.05 for MRI versus CT). Transpapillary stenting, advanced tumor extension (>T2), large tumor size (>2 cm), tumor differentiation, and endoscopic appearance of tumor growth did not significantly influence EUS accuracy in T or N staging (p > 0.05). A mpullary carcinomas often manifest with jaundice, abdominal pain, and anemia. They tend to have a higher resectability rate and better subsequent prognosis than other periampullary carcinomas. 1,2 It has been reported that if ampullary carcinoma invades the pancreas, the incidence of lymph node metastasis increases, and prognosis is poor. 3,4 However, there is substantial support in the literature for local resection of T1 ampullary tumors because of the very low incidence of lymph node metastasis. 5,6 Accurate staging of ampullary tumors is therefore critical for surgical planning and predicting the patient's prognosis. Conclusion. EUS was superior to CT and was equiv-Radial endosonography (EUS) provides highresolution sonograms by placing a high-frequency (7.5-12 MHz) ultrasound probe in close proximity to the periampullary region, avoiding interference from soft tissues and bowel gas. EUS can clearly delineate the pancreatic

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Reappraisal of endosonography of ampullary tumors: Correlation with transabdominal sonography, CT, and MRI

Chen

Yang

Yeh

et al. 2008

J of Clinical Ultrasound

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“…The resolution of magnetic resonance imaging (MRI) is somewhat lower than that of EUS (0.1 vs. 1.5 mm), resulting in lower sensitivity in the detection of small stones. According to the literature, MRI has the sensitivity of 97.5-100%, specificity of 72.7-100%, positive predictive value of 62.5-100% and negative predictive value of 81.1-100% for the detection of bile duct stones 35,36 . In patients with the narrow bile duct and minute stones, the MRI sensitivity drops to 40-60% (ref.…”

Section: Resultsmentioning

confidence: 99%

Endosonography Versus Endoscopic Retrograde Cholangiopancreatography in Diagnosing Extrahepatic Biliary Obstruction

Angelo¹,

Procházka²,

Holinka³

et al. 2011

BIOMED PAP

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Objective. Endosonography (EUS) performed prior to endoscopic retrograde cholangiopancreatography (ERCP) or surgery in patients with a low to moderate probability of choledocholithiasis can reduce morbidity, mortality and costs.Aims. This study aimed at evaluating the sensitivity and specificity of EUS and transabdominal ultrasonography (TUS) compared to ERCP in a cohort of 100 patients diagnosed with extrahepatic biliary obstruction.Methods. There were four working groups. The first group processed the initial data including history, physical examination and assessment of laboratory markers of cholestasis. The second group examined TUS. The third group examined the pancreas and biliary tree using EUS, always prior to ERCP. The fourth working group carried out ERCP.Results. The sensitivity and accuracy of EUS in the diagnosis of common bile duct dilatation were 84% and 83%, respectively, i.e. significantly higher (p=0.0001) than TUS (46% and 66%, respectively). The specificities of methods (82%, 91%) were not significantly different (p=0.218). The sensitivity and accuracy of EUS in the diagnosis of pathological content of the common bile duct were 88% and 92%, respectively, i.e. significantly higher (p<0.0001) than TUS (33% and 64%). The specificities of the methods (96%, 94%) were not significantly different (p=0.641).The incidence of choledocholithiasis in the high-risk group was significantly higher than in the moderate-risk group (p=0.012).Conclusion. Radial EUS is a method with high sensitivity, specificity, positive and negative predictive values. It should therefore be preferred to ERCP in patients with low or moderate risk of choledocholithiasis.

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Endoscopic Ultrasonography

Khashab¹,

Canto²

2015

Yamada' S Textbook of Gastroenterology

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Extrahepatic Biliary Obstruction: Magnetic Resonance Imaging Compared With Endoscopic Ultrasonography

Abstract: In our study MR imaging was as accurate as EUS in the diagnosis of extrahepatic biliary obstruction.

Cited by 107 publications

References 30 publications

Reappraisal of endosonography of ampullary tumors: Correlation with transabdominal sonography, CT, and MRI

Reappraisal of endosonography of ampullary tumors: Correlation with transabdominal sonography, CT, and MRI

Endosonography Versus Endoscopic Retrograde Cholangiopancreatography in Diagnosing Extrahepatic Biliary Obstruction

Endoscopic Ultrasonography

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