[The value of magnetic resonance tomography (MRT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic tumors].
OBJECTIVE
To prospectively evaluate the role of MRI including MR cholangiopancreatography (MRCP) compared to endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic cancer.


METHODS
ERCP and MRI including MRCP were performed in 52 patients with suspected pancreatic cancer. MRCP was obtained using a single-shot RARE technique. The results of axial images and MRCP were compared to concurrently performed ERCP examinations. The standards of reference were the surgical and pathological findings, respectively. Image quality of MRCP was assessed using a three-step-score (1 = good, 2 = fair, 3 = nondiagnostic).


RESULTS
In 88% of the cases the MRCP was of good quality. Only in 4% was MRCP non-diagnostic. The combination of MRI and MRCP showed an overall accuracy of 88%, whereas the overall accuracies of MRCP alone and ERCP were 80%, and 85%, respectively. The positive predictive values of MRI/MRCP, MRCP alone, and ERCP were 91%, 85%, and 88%, respectively.


CONCLUSIONS
For the detection of pancreatic cancer MRI including MRCP is comparable to ERCP and can be regarded as the method of choice in patients with suspected pancreatic cancer. ERCP is the procedure of choice in patients with contraindications to MRI and in patients in whom additional therapeutic procedures are performed.
Diehl
S J
SJ
Institut für Klinische Radiologie, Klinikum Mannheim gGmbH, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg. Diehl@ikr.ma.uni-heidelberg.de
Lehmann
K J
KJ
Gaa
J
J
Meier-Willersen
H J
HJ
Wendl
K
K
Georgi
M
M
D000230:Adenocarcinoma / Q000175:diagnosis*; D001652:Bile Ducts / Q000473:pathology*; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D011300:Preoperative Care; D011446:Prospective Studies; D012119:Respiration; D012680:Sensitivity and Specificity
Wertigkeit von Magnetresonanztomographie (MRT), Magnetresonanz-Cholangiopankreatikographie (MRCP) und endoskopischer retrograder Cholangiopankreatikographie (ERCP) bei der Diagnose von Pankreastumoren.