Paediatric MRCP: 10 year experience with 195 patients

Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography

“…In patients with APBDU, bile reflux can occur due to a dysfunctional sphincter of Oddi or because the common channel becomes obstructed by a stone, sludge, or protein plugs [ 26 ]. The maximum length of the normal common channel in children increases with age, and the maximum length of the common channel is reportedly 3 mm in infants and 5 mm in children between 3-15 years of age [ 27 28 ]. A common channel >5 mm would be considered abnormal in children [ 7 ].…”

Paediatric Gastrointestinal Endoscopy

“…Currently, the majority of ERCPs in children are therapeutic as MRCP has mostly replaced diagnostic ERCP but this is not reflected in the literature. [199]. MRCP accurately depicts pancreatico-biliary anatomy and related diseases in children and secretin stimulation can enhance the visualization of non-dilated pancreatic ducts thereby improving diagnostic sensitivity [200].…”

Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline

“…Of note, the fusiform and small cystic dilatations of intrahepatic (mostly peripheral) bile ducts as observed in patients with congenital hepatic fibrosis and autosomal recessive polycystic kidney disease should not be misdiagnosed as PSC (11). Another differential diagnosis is the peculiar cholangiographic phenotype of adult forms of ABCB4/MDR3 deficency which may be characterized by large uni-or multifocal spindle-shaped intra-hepatic bile duct dilatations with or without apparent bile duct stenosis (12,26).…”

“…Although ERCP has been regarded as the standard of reference in diagnosing PSC, MRC is now recommended as first line non-invasive imaging method for patients with suspected PSC, offering comparable accuracy (except in in early stage of PSC restricted into intrahepatic bile ducts and the rare cases of contraindications to MRC) (8)(9)(10)(11)(12). A meta-analysis based on six studies using ERCP as a reference method concluded that MRC has high sensitivity and specificity (0.86 and 0.94, respectively) for the diagnosis of PSC (13).…”