[Evaluation of a new sequence of magnetic resonance cholangio-pancreatography in thick cut and one shot acquisition].
OBJECTIVE
To assess the accuracy and reproducibility of a new magnetic resonance cholangiopancreatography sequence (MRCP), using long echo time and "single shot" acquisition (providing high-contrast thick slices: 20 mm or more), in the morphological analysis of the biliary tree and pancreatic ducts.


METHODS
Fifty four patients with biliary and/or pancreatic disease were investigated with MRCP "single shot" thick slices. Biliary ducts were explored with MRCP "single shot", coronal and oblique coronal 20 mm thick slices on a 256 x 256 matrix. Natives pictures were reviewed by three independent radiologists, from three different institutions. MRCP results were compared with reference examinations in 54 cases (direct biligraphy methods: 54, CT scan: 11, endoscopic ultrasonography: 6, surgery: 6).


RESULTS
For detection of bile duct dilatation, the agreement of MRCP "single shot" thick slices was more than 96% (Kappa > 0.92) and the inter-observer agreement was excellent (Kappa=0.92). For detection of biliary tree and/or pancreatic duct obstruction, MRCP "single shot" thick slice sensitivity was above 89% and specificity was 75%. The malignant nature of the lesions was determined with a sensitivity of 100% and a specificity of 92%. MRCP "single shot" thick slices could not differentiate pancreatic carcinomas from distal main bile duct cholangiocarcinomas. MRCP "single shot" thick slices did not detect small stones ( 3 mm) of the common bile duct.


CONCLUSIONS
The excellent sensitivity, specificity and inter-observer agreement of MRCP "single shot" thick slices can be used to limit invasive imaging methods in the diagnosis of extrahepatic cholestasis.
Mougenel
J L
JL
Service d'Hépato-Gastroentérologie, CHU Nancy.
Hudziak
H
H
Ernst
O
O
Dupas
B
B
Lefevre
F
F
Barraud
H
H
Watelet
J
J
Cezard
O
O
Regent
D
D
Bigard
M A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis; D001652:Bile Ducts / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000473:pathology; D018281:Cholangiocarcinoma / Q000175:diagnosis; D002758:Cholangiography; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000473:pathology; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity