Magnetic resonance cholangiopancreatography in primary sclerosing cholangitis in children.
BACKGROUND
Primary sclerosing cholangitis (PSC) is a chronic cholestatic syndrome of unknown aetiology. Diagnosis is based on clinical and laboratory data in conjunction with imaging of the biliary tree using endoscopic retrograde cholangiopancreatography (ERCP).


OBJECTIVE
: To evaluate the clinical usefulness of MR cholangiopancreatography (MRCP) in the diagnosis of PSC in children.


METHODS
Twenty-one children with clinical and laboratory suspicion of PSC were enrolled. MRCP was performed using a superconductive system with a phased-array coil. Rapid acquisition with relaxation enhancement (RARE) T2-weighted and half-Fourier single-shot turbo-spin-echo (HASTE) sequences were used. The distribution and extent of biliary tree changes were evaluated and classified according to Majoie's classification. A comparison between MRCP and ERCP was performed blind in all cases to evaluate the usefulness of MRI.


RESULTS
In 13 cases (62%), MRCP showed abnormalities of the biliary tree which were considered positive for PSC, while in 8 cases there were no signs of PSC. Both MRCP and ERCP correctly identified changes in 13 cases and excluded abnormalities in 5. MRCP had a sensitivity of 81%, specificity of 100%, negative predictive value of 62%, positive predictive value of 100% and an accuracy of 85%.


CONCLUSIONS
MRCP can be proposed as the preliminary non-invasive imaging modality for the diagnosis of PSC in children.
Ferrara
Calogero
C
Department of Radiology, MR Centre F. Angelini, University of Ancona, Ospedale Torrette, Via Conca, 60020 Torrette, Ancona, Italy.
Valeri
Gianluca
G
Salvolini
Luca
L
Giovagnoni
Andrea
A
D000293:Adolescent; D001652:Bile Ducts / Q000473:pathology*; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010183:Pancreatic Ducts / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity