Magnetic resonance cholangiography: comparison with endoscopic retrograde cholangiopancreatography.
OBJECTIVE
Magnetic resonance cholangiography (MRC) is a noninvasive diagnostic modality capable of producing high-quality images of the biliary tree. The purpose of this study was to determine in a prospective, blinded fashion the sensitivity and specificity of three-dimensional fast spin-echo (3D FSE) MRC for the evaluation of biliary tract abnormalities.


METHODS
Forty-six patients referred for elective direct cholangiography (45 endoscopic retrograde cholangiopancreatography and 1 percutaneous transhepatic cholangiography) were studied prospectively with 3D FSE MRC during a 1-year period. All images were interpreted blindly by two radiologists. The presence of dilatation, strictures, and intraductal abnormalities was recorded. Sensitivity and specificity of 3D FSE MRC were determined using findings on direct cholangiography as the gold standard.


RESULTS
MRC images of diagnostic quality were obtained in 44 (95.7%) of the patients. Sensitivity for the detection of bile duct dilatation (n = 27), biliary strictures (n = 10), and intraductal abnormalities (n = 7) was 96.3%, 90%, and 100%, respectively. In addition, the MRC showed 16 of 17 patients with normal bile ducts (specificity, 94.1%).


CONCLUSIONS
MRC has a very high sensitivity and specificity in the evaluation of the biliary tract. Based on these data, we believe that the efficacy of MRC using 3D FSE is sufficient to warrant its use in the routine diagnosis of biliary tract disease.
Soto
J A
JA
Department of Radiology, Boston University Medical Center, Massachusetts, USA.
Barish
M A
MA
Yucel
E K
EK
Siegenberg
D
D
Ferrucci
J T
JT
Chuttani
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000473:pathology*; D001660:Biliary Tract Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity