Magnetic resonance cholangiopancreatography and contrast-enhanced magnetic resonance cholangiopancreatography versus endoscopic ultrasonography in the diagnosis of extrahepatic biliary pathology.
OBJECTIVE
This study compared the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) in evaluating the cause of extrahepatic bile duct dilatation.


METHODS
Forty-five patients (26 men, mean age 57 years) with extrahepatic biliary dilatation, as shown by transabdominal ultrasound, with or without elevated biliary and pancreatic serum indices, were prospectively studied with MRCP and EUS between September 2007 and October 2008. EUS and MRCP were performed within no more than 24 h of each other to reduce the possibility of changes due to stone migration. Image analysis was carried out in a double-blind fashion.


RESULTS
MRCP had 88.9% diagnostic accuracy, 91.9% sensitivity and 75% specificity, with 94.4% positive predictive value and 66.7% negative predictive value. EUS had 93.3% diagnostic accuracy, 97.3% sensitivity and 75% specificity; the positive and negative predictive values were 94.7% and 85.7%, respectively.


CONCLUSIONS
MRCP and EUS do not show significant statistical differences in diagnostic accuracy. MRCP is an accurate, noninvasive modality in the study of extrahepatic biliary pathology. EUS is especially reliable in patients with extrahepatic biliary obstruction caused by endoluminal sludge.
Palmucci
S
S
Sezione di Scienze Radiologiche - Dipartimento Dogira, Azienda Ospedaliero Universitaria Policlinico - Vittorio Emanuele, Via Santa Sofia 78, Catania, Italy. stefanopalmucci@hotmail.com
Mauro
L A
LA
La Scola
S
S
Incarbone
S
S
Bonanno
G
G
Milone
P
P
Russo
A
A
Ettorre
G C
GC
D017734:Bile Ducts, Extrahepatic; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D004108:Dilatation, Pathologic; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine