Extrahepatic biliary diseases: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatography.
OBJECTIVE
To assess the diagnostic value of three-dimensional (3D) magnetic resonance (MR) cholangiopancreatography versus endoscopic retrograde cholangiopancreatography (ERCP) in various pancreaticobiliary diseases.


METHODS
Forty-six consecutive adult patients suspected to have extrahepatic biliary disease were examined. Breath-hold 3D steady-state free-precession MR cholangiopancreatography was performed. Correct determination of the level of biliary obstruction (n = 23) and of the cause of lesions (n = 46) was independently assessed with both MR cholangiopancreatography and ERCP by two readers blinded to the diagnosis. Results were compared. The overall diagnostic accuracies of both modalities also were compared.


RESULTS
Level of obstruction was accurate in 91% (21 of 23) with MR cholangiopancreatography and in 83% (19 of 23) with ERCP (P > .05). The sensitivity, specificity, and accuracy in distinguishing malignant from benign lesions were 81%, 92%, and 87%, respectively, for MR cholangiopancreatography and 71%, 92%, and 83%, respectively, for ERCP. However, the differences were not significant (P > .05). The overall diagnostic accuracies of MR cholangiopancreatography and ERCP were 72% and 61% (P > .05), respectively.


CONCLUSIONS
3D MR cholangiopancreatography not only is fast and reliable in evaluating the extrahepatic bile duct, but also offers a diagnostic value equivalent to that of ERCP.
Lee
M G
MG
Department of Diagnostic Radiology, University of Ulsan Asan Medical Center, Songpa-Ku, Seoul, South Korea.
Lee
H J
HJ
Kim
M H
MH
Kang
E M
EM
Kim
Y H
YH
Lee
S G
SG
Kim
P N
PN
Ha
H K
HK
Auh
Y H
YH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity