Abstract Purpose. This study compared the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP)and endoscopic ultrasonography (EUS) in evaluating the cause of extrahepatic bile duct dilatation. Materials and methods. Forty-five patients (26 men, mean age 57 years) with extrahepatic biliary dilatation, as shown by transabdominal ultrasound, with or without elevated biliary and pancreatic serum indices, were prospectively studied with MRCP and EUS between September 2007 and October 2008. EUS and MRCP were performed within no more than 24 h of each other to reduce the possibility of changes due to stone migration. Image analysis was carried out in a double-blind fashion. Results. MRCP had 88.9% diagnostic accuracy, 91.9% sensitivity and 75% specificity, with 94.4% positive predictive value and 66.7% negative predictive value. EUS had 93.3% diagnostic accuracy, 97.3% sensitivity and 75% specificity; the positive and negative predictive values were 94.7% and 85.7%, respectively. Conclusions. MRCP and EUS do not show significant statistical differences in diagnostic accuracy. MRCP is an accurate, noninvasive modality in the study of extrahepaticbiliary pathology. EUS is especially reliable in patients with extrahepatic biliary obstruction caused by endoluminal sludge.
Riassunto Obiettivo. Scopo di questo lavoro è stato confrontare l’accuratezza diagnostica della colangiopancreatografia con risonanza magnetica (CPRM) e dell’ecografia endoscopica (EUS) nel valutare la causa di dilatazione in pazienti con aumentato diametro della via biliare extraepatica. Materiali e metodi. Quarantacinque pazienti (età media 57 anni, 26 maschi) sono stati studiati da settembre 2007 a ottobre 2008 con CPRM e EUS. Sono stati inclusi nello studio pazienti con dilatazione della via biliare extraepatica rilevata all’ecografia trans-addominale, con o senza innalzamento degli indici sierologici biliopancreatici. Lo studio è stato condotto in modalità prospettica ed in doppio cieco. Per ridurre al minimo possibili variazioni legate alla migrazione di calcoli, EUS e CPRM sono state eseguite con intervallo non superiore alle 24 ore. Risultati. La CPRM ha dimostrato accuratezza diagnostica, sensibilità e specificità rispettivamente dell’88,9%, 91,9% e 75%, con valore predittivo positivo del 94,4% e valore predittivo negativo del 66,7%. La EUS ha evidenziato accuratezza diagnostica, sensibilità especificità del 93,3%, 97,3% e 75%; valore predittivo positivo e negativo sono stati rispettivamente 94,7% e 85,7%. Conclusioni. CPRM ed EUS non presentano differenze statisticamente significative nell’accuratezza diagnostica. La CPRM è metodica accurata non invasiva nella patologia biliare extraepatica; la EUS è particolarmente attendibile nei pazienti con ostruzione biliare extra-epatica da sludge.
Magnetic resonance cholangiopancreatography and contrast-enhanced magnetic resonance cholangiopancreatography versus endoscopic ultrasonography in the diagnosis of extrahepatic biliary pathology
PALMUCCI, STEFANO;MILONE, Pietro;
2010-01-01
Abstract
Abstract Purpose. This study compared the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP)and endoscopic ultrasonography (EUS) in evaluating the cause of extrahepatic bile duct dilatation. Materials and methods. Forty-five patients (26 men, mean age 57 years) with extrahepatic biliary dilatation, as shown by transabdominal ultrasound, with or without elevated biliary and pancreatic serum indices, were prospectively studied with MRCP and EUS between September 2007 and October 2008. EUS and MRCP were performed within no more than 24 h of each other to reduce the possibility of changes due to stone migration. Image analysis was carried out in a double-blind fashion. Results. MRCP had 88.9% diagnostic accuracy, 91.9% sensitivity and 75% specificity, with 94.4% positive predictive value and 66.7% negative predictive value. EUS had 93.3% diagnostic accuracy, 97.3% sensitivity and 75% specificity; the positive and negative predictive values were 94.7% and 85.7%, respectively. Conclusions. MRCP and EUS do not show significant statistical differences in diagnostic accuracy. MRCP is an accurate, noninvasive modality in the study of extrahepaticbiliary pathology. EUS is especially reliable in patients with extrahepatic biliary obstruction caused by endoluminal sludge.File | Dimensione | Formato | |
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Radiol med (2010) 115, 732–746 Magnetic resonance cholangiopancreatography and contrast-enhanced magnetic resonance cholangiopancreatography versus endoscopic ultrasonography in the diagnosis of .pdf
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