MR cholangiopancreatography: prospective comparison of 3-dimensional turbo spin echo and single-shot turbo spin echo with ERCP.
OBJECTIVE
Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive technique for examination of the biliopancreatic tract. Respiratory-triggered 3-dimensional turbo spin echo (3DTSE RT) and breath-hold thick slab single-shot turbo spin echo (ssTSE BH) are both useful MRCP techniques. The purpose of this study was to compare these 2 sequences with endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliary tract disease.


METHODS
Forty four patients with suspected biliary obstruction were recruited to receive MRCP within 3 days before ERCP. MRCP was performed using both 3DTSE RT with maximum intensity projection images and ssTSE BH. ERCP was performed and assessed by 2 endoscopists.


RESULTS
MRCP was successfully performed in all patients, whereas ERCP failed in 6 patients (13.6%). MRCP was effective in detecting the presence of choledocholithiasis in 13 of 14 patients, ERCP in 12 of 12, and 2 failed ERCP. MRCP was effective in detecting benign biliary obstruction in 18 of 19 patients, and ERCP in 15 of 15, but 4 patients failed ERCP and choledocholithiasis was misdiagnosed by MRCP in 1 patient. Both MRCP and ERCP correctly diagnosed malignant bile duct obstruction in 10 of 11 patients, and both misdiagnosed that condition as benign obstruction in 1 patient. There was no significant difference between MRCP and successful ERCP in detecting lesions. MRCP was significantly better than ERCP when both successful and failed ERCP were encountered (p = 0.0498). Both 3DTSE RT and ssTSE BH produced the same results in depicting the biliary ducts and lesions in 37 patients (84.1%). Four patients (9.1%) showed better images on 3DTSE RT, whereas 3 patients (6.8%) showed better images on ssTSE BH.


CONCLUSIONS
3DTSE RT and the ssTSE BH were complementary to each other in MRCP studies. Using these 2 techniques, MRCP has a high successful rate and diagnostic accuracy when compared with ERCP in detecting bile duct disease.
Chen
Ran-Chou
RC
Department of Radiology, Taipei Municipal Jen-Ai Hospital, and Department of Radiology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Lin
Kuang-Yang
KY
Lii
Jiunn-Ming
JM
Yang
Min-Ta
MT
Chen
Wei-Tsung
WT
Tu
Hsing-Yang
HY
Wang
Chaur-Shine
CS
D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis*; D003951:Diagnostic Errors; D042882:Gallstones / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity