Usefulness of axial planes of helical computed tomography for diagnosis of pancreaticobiliary maljunction in early infants with negative findings on magnetic resonance cholangiopancreatography.
OBJECTIVE
Magnetic resonance cholangiopancreatography (MRCP) is not sufficient to detect pancreaticobiliary maljunction (PBM) in young infants because the main pancreatic duct is not visualized and respiratory artifacts occur. To our knowledge, there are no reports highlighting the diagnostic accuracy of evaluation using the axial planes of helical computed tomographic (CT) scanning with contrast medium instead of 3-dimensional (3D) reconstruction. The aim of this study was to describe our experience and the characteristics of 3 children with PBM diagnosed using the axial planes of helical CT with contrast medium, although they showed negative findings of PBM by MRCP, instead of 3D reconstruction.


METHODS
Three patients aged from 1 month to 3 years were diagnosed with PBM using the axial planes of helical CT with contrast medium though MRCP could not show the common channel and/or the entrance of the common channel into the duodenum.


RESULTS
In all 3 patients, PBM of the common channel was not revealed by MRCP. On the other hand, axial planes of contrast-enhanced helical CT scans showed PBM clearly.


CONCLUSIONS
Our experience suggests that axial planes of the contrast-enhanced helical CT scan comprise an accurate tool for the diagnosis of fusiform-type PBM and could replace MRCP in younger children. Further studies are necessary for better assessment of the potential advantages and pitfalls of this modality.
Okada
Tadao
T
Department of Pediatric Surgery, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan. okadata@med.hokudai.ac.jp
Sasaki
Fumiaki
F
Honda
Shouhei
S
Naitou
Satsuki
S
Onodera
Yuya
Y
Todo
Satoru
S
D002675:Child, Preschool; D049448:Cholangiopancreatography, Magnetic Resonance; D003135:Common Bile Duct / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D000013:Congenital Abnormalities / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010183:Pancreatic Ducts / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome