Highly resolved free-breathing magnetic resonance cholangiopancreatography in the diagnostic workup of pancreaticobiliary diseases in infants and young children—initial experiences

Schaefer, Juergen F.; Kirschner, Hans‐Joachim; Lichy, Matthias P.; Schick, Fritz; Claussen, Claus D.; Fuchs, Joerg

doi:10.1016/j.jpedsurg.2006.05.052

Cited by 28 publications

(12 citation statements)

References 14 publications

(19 reference statements)

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“…Initially, MRCP was extremely limited in its diagnostic accuracy and used sparingly in extremely cooperative patients. The advent of respiratory trigger and non-breath holding techniques gradually enabled MRCP use in less cooperative patients, especially children [43][44][45][46] . Concurrently, rapid imaging techniques including HASTE/single-shot FSE/single-shot turbo spin echo (TSE) decreased image acquisition time to 2-5 s. Today, MRCP is utilized to study the biliary system in almost all populations [47,48] .…”

Section: Mrcp Vs Ercpmentioning

confidence: 99%

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: Mrcp Vs Ercpmentioning

confidence: 99%

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

Sacher

Davis²,

Sleeman³

et al. 2013

WJR

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“…Schaefer et al [24] reported the MRCP findings of seven children (ages 3 months to 5.7 years) evaluated for suspected pancreatobiliary disease. MRCP detected abnormalities in six children and was normal in one.…”

Section: Review Of Studies Comparing Mrcp To Gold Standard Evaluationmentioning

confidence: 99%

The use of magnetic resonance cholangiopancreatography in children

Tipnis¹,

Werlin

2007

Curr Gastroenterol Rep

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Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method to evaluate a wide variety of pancreatobiliary disorders. These disorders include choledochal cyst, cholelithiasis, choledocholithiasis, biliary atresia, Caroli's disease, primary sclerosing cholangitis, disorders of the pancreatobiliary junction, pancreas divisum, and pancreatic duct abnormalities related to chronic pancreatitis. The use of MRCP in children is increasing as experience with MRCP grows, and its technological accuracy rivals that of endoscopic evaluation. We review the current state of MRCP use in children.

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“…To date, intraoperative cholangiography (IOC) has been the gold standard imaging modality to type choledochal cysts and to devise a strategy for surgical resection [3]. Recent imaging alternatives, including magnetic resonance cholangiopancreatography (MRCP) [6–9], endoscopic retrograde cholangiopancreatography (ERCP) [10], and three-dimensional US [11], have been demonstrated to be safe and effective measures in the diagnosis and mapping of pediatric biliary anomalies. However, few comparative studies have been done using these varied modalities in the pediatric population [12].…”

Section: Introductionmentioning

confidence: 99%

Concordance of imaging modalities and cost minimization in the diagnosis of pediatric choledochal cysts

et al. 2012

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Purpose Given evolving imaging technologies, we noted significant variation in the diagnostic evaluation of pediatric choledochal cysts (CDC). To streamline the diagnostic approach to CDC, and minimize associated expenses, we compared typing accuracy and costs of ultrasound (US), intraoperative cholangiography (IOC), and magnetic resonance cholangiopancreatography (MRCP). Methods Records of 30 consecutive pediatric CDC patients were reviewed. Blinded to all clinical data, two pediatric radiologists reviewed all US, MRCPs, and IOCs to type CDCs according to the Todani classification. When compared with pathologic findings, the concordance between and accuracy of each diagnostic test were determined. Inflation-adjusted procedure charges and collections for imaging modalities were analyzed. Results Mean typing accuracy overlapped for US, IOC, and MRCP. Inter-rater reliability was 87 % for US (κ = 0.77), 80 % for IOC (κ = 0.62), and 60 % for MRCP (κ = 0.37). MRCP procedure charges ($1204.69) and collections ($420.85) exceeded IOC and US combined ($264.80 charges, p = 0.0002; $93.40 collections, p = 0.0021). Conclusion Our data support the use of US alone in the diagnosis of pediatric CDC when no intrahepatic biliary ductal dilatation is visualized. However, when dilated intrahepatic ducts are encountered on US, MRCP should be utilized to distinguish a type I from a type IV CDC, which may alter the operative approach.

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Highly resolved free-breathing magnetic resonance cholangiopancreatography in the diagnostic workup of pancreaticobiliary diseases in infants and young children—initial experiences

Cited by 28 publications

References 14 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

The use of magnetic resonance cholangiopancreatography in children

Concordance of imaging modalities and cost minimization in the diagnosis of pediatric choledochal cysts

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