Comparison between magnetic resonance cholangiopancreatography and ERCP for evaluation of the pancreatic duct.
OBJECTIVE
To date, ERCP has been the reference technique in the diagnosis of pancreatic duct pathology. The aim of the present study was to evaluate the accuracy of magnetic resonance cholangiopancreatography (MRCP), a relatively new, noninvasive diagnostic method, in studying the pancreatic duct.


METHODS
A prospective 15-month study was done of 78 patients with suspected biliopancreatic pathology and indications for ERCP. In all cases, MRCP was performed <72 h before ERCP. Both techniques were used to assess the size of the pancreatic tract (normal or dilated), the presence or absence of obstruction, the level of obstruction where present, and its etiology.


RESULTS
Both techniques found the pancreatic tract to be normal and nondilated in 60 patients. The specificity and sensitivity of MRCP in evaluating the normal pancreatic duct were 98% and 94%, respectively. In nine cases, a stenotic duct of Wirsung was detected (seven at the head of the pancreas and two in the body), with the same correlation being shown by ERCP (sensitivity 100%). The sensitivity and specificity of MRCP relating to diffuse irregular and dilated morphologies of the entire pancreatic duct was 86% and 100%, respectively. Nine patients were diagnosed with pancreatic neoplasms by both techniques, with an accuracy of 100%. Four patients presented chronic pancreatitis, which was correctly diagnosed by MRCP in each case.


CONCLUSIONS
MRCP is an effective technique for evaluating both the normal and diseased duct of Wirsung, and for establishing the underlying pathology.
Calvo
Mari M
MM
Department of Gastroenterology and Radiology (OSATEK-RM), Galdakao Hospital, Vizcaya, Spain.
Bujanda
Luis
L
Calderón
Angel
A
Heras
Iñaki
I
Cabriada
José L
JL
Bernal
Antonio
A
Orive
Victor
V
Astigarraga
Elena
E
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging* / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity