The use of magnetic resonance cholangiopancreatography in children

Tipnis, Neelesh A.; Werlin, Steven L.

doi:10.1007/s11894-007-0023-2

Cited by 36 publications

(13 citation statements)

References 31 publications

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“…In our experience, abdominal US diagnosed 19 cases (50%) and accurately classified the cyst type in 11 cases (28.8%), while MRCP diagnosed 38 cases (92.7%) and accurately classified the cyst type in 36 cases (87.8%). These findings were consistent with other studies [2,14,15] .…”

Section: B a B Asupporting

confidence: 94%

Diagnosis and management of choledochal cyst: 20 years of single center experience

Hak

Shehta

Hamed

2014

WJG

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We report the first case series from Africa and the Middle East on choledochal cyst, a disease which shows significant geographical distribution with high incidence in the Asian population. In this study, the epidemiological data of the patients are presented and analyzed. Attention was paid to diagnostic imaging and its accuracy in the diagnosis and classification of choledochal cyst. Most cases of choledochal cyst disease have type I and IV-A cysts according to the Todani classification system, which support the etiological theories of choledochal cyst, especially Babbitt's theory of the anomalous pancreaticobiliary duct junction, which are clearly stated. The difficulties and hazards of surgical management and methods used to avoid operative complications are clarified. Early and late postoperative complications are also included. This study should be followed by multicenter studies throughout Egypt to help assess the incidence of choledochal cysts in one of the largest populations in Africa and the Middle East.

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Section: B a B Asupporting

confidence: 94%

Diagnosis and management of choledochal cyst: 20 years of single center experience

Hak

Shehta

Hamed

2014

WJG

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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: 87%

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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“…a Focal hemorrhage (arrowhead) and stromal fibrotic change (arrow) and b dense neutrophilic infiltrates of the cyst were observed reported to serve as an ideal, noninvasive, and complete diagnostic modality for choledochal cysts as it ensures accurate visualization of the entire pancreatobiliary system [22]. The sensitivity, specificity, and diagnostic accuracy of this technique are reported to approximate 90% [5,23]. Based on our experiences, MRCP is recommended as the diagnostic test of choice to evaluate anatomic abnormalities of the pancreatobiliary tract in children after conventional image techniques have been applied or when conventional techniques do not reveal a clear need for surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Choledochal cysts in infants and children: experiences over a 20-year period at a single institution

et al. 2011

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This analysis was undertaken to compare the clinicopathological features of infants with choledochal cysts to those of older children with these entities and to evaluate the surgical outcomes for both subject groups. The medical records of all children admitted to the Cathay General Hospital with choledochal cysts over a 20-year period were retrospectively reviewed. Twenty-five subjects were included and divided into the infant (<1 year at presentation; 8 subjects) and classical pediatric (1-18 years at presentation; 17 subjects) groups. Anatomical subtypes were: IA (16), IC (6), and IVA (3). The median biliary amylase value was markedly elevated for the pediatric group but not for the infant group. Most (82.4%) patients in the pediatric group, but none in the infant group, presented with abdominal pain. Jaundice and clay-colored stool were present in all patients in the infant group but only 35% of those in the pediatric group. All patients underwent choledochocystectomy and Roux-en-Y hepaticojejunostomy with good outcomes. Neonates/infants with choledochal cysts present differently from older children with these entities. Amylase measurements may serve to distinguish biliary atresia with cystic dilatation from choledochal cyst in neonates/infants. Prognosis following radical cyst excision and reconstruction with Roux-en-Y hepaticojejunostomy is excellent.

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The use of magnetic resonance cholangiopancreatography in children

Cited by 36 publications

References 31 publications

Diagnosis and management of choledochal cyst: 20 years of single center experience

Diagnosis and management of choledochal cyst: 20 years of single center experience

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

Choledochal cysts in infants and children: experiences over a 20-year period at a single institution

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