Imaging diagnosis of pancreato-biliary diseases: a control study.
OBJECTIVE
To evaluate the clinical value of various imageological methods in diagnosing the pancreato-biliary diseases and to seek the optimal procedure.


METHODS
Eighty-two cases of pancreato-biliary diseases confirmed by surgery and pathology were analyzed. There were 38 cases of cholelithiasis, 34 cases of pancreato-biliary tumors and 10 other cases. The imageological methods included B-US, CT, ERCP, PTC, cross-sectional MRI and MR cholangiopancreatography (MRCP).


RESULTS
The accuracy rate of MRCP in detecting the location of pancreato-biliary obstruction was 100%. In differentiating malignant from benign obstruction, the sensitivity of the combination of MRCP and cross-sectional MRI was 82.3%, the specificity was 93.8%, and the accuracy rate was 89.0%. The accuracy rate for determining the nature of obstruction was 87.8%, which was superior to that of B-US (P=0.0000) and CT (P=0.0330), but there was no significant difference between direct cholangiopancreatography and the combination of MRCP and conventional MRI (P=0.6666).


CONCLUSIONS
In most cases, MRCP can substitute direct cholangiopancreatography for diagnosis. The combination of MRCP and cross-sectional MRI should be considered as an important means in diagnosing the pancreato-biliary diseases, pre-operative assessment and post-operative follow-ups.
Zhong
Liang
L
Department of Radiology, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China. zhong-liang@online.sh.cn
Yao
Qiu-Ying
QY
Li
Lei
L
Xu
Jian-Rong
JR
D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis; D015529:Choledochal Cyst / Q000175:diagnosis; D002769:Cholelithiasis / Q000175:diagnosis; D002908:Chronic Disease; D005188:False Negative Reactions; D005189:False Positive Reactions; D005705:Gallbladder Diseases / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000175:diagnosis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D010182:Pancreatic Diseases / Q000145:classification / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D010195:Pancreatitis / Q000175:diagnosis; D012372:ROC Curve; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography