MR and ultrasound in screening of patients with suspected biliary tract disease.
OBJECTIVE
The diagnostic value and cost-efficiency of MR imaging were compared with US before endoscopic retrograde cholangiopancreatography (ERCP) in patients with clinically suspected biliary tract disease.


METHODS
In a prospective study of 219 patients, 85 were examined with both MR and US before ERCP.


RESULTS
To find the correct diagnosis in the jaundiced patients the sensitivity of US, MR and ERCP was 53%, 93%, and 89%, respectively. In the patients with abdominal upper quadrant pain and normal serum bilirubin, the sensitivity of US, MR and ERCP was 50%, 100% and 70%, respectively. Examination with MR costs four times more than US. Screening with US and supplemental MR in non-diagnostic cases would cost 80% of the total amount compared to screening with MR only.


CONCLUSIONS
MR had a higher sensitivity than US for diagnosing biliary tract disease and MR was superior to US in visualising stones in the common bile duct and in diagnosing the cause of cholestasis. However, screening with US and supplemental MR in non-diagnostic cases is at present most cost-effective. With increased accessibility and slightly lower costs, MR will probably replace US as screening method in patients with suspected biliary tract disease.
Håkansson
K
K
Department of Radiology, Kalmar Hospital, SE-391 85 Kalmar, Sweden.
Ekberg
O
O
Håkansson
H-O
HO
Leander
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000191:economics / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000191:economics*