title: Diagnostic accuracy of endoscopic ultrasonography in patients with inconclusive magnetic resonance imaging diagnosis of biliopancreatic abnormalities.
abstract: OBJECTIVE
  To determine the sensitivity and specificity of endoscopic ultrasonography (EUS) in patients with inconclusive magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) in pancreatobiliary abnormalities.
  
  
  METHODS
  During 10 months, patients with pancreatobiliary diseases referred to endoscopic retrograde cholangiopancreatography (ERCP) because of inconclusive MRI/MRCP diagnosis were scheduled to undergo endoscopic ultrasonography. Patients were divided into four major groups: patients with (i) resectable periampullary neoplasms who were referred to a surgeon, (ii) unresectable periampullary cancer who underwent ERCP for biliary stenting, (iii) bile duct stone who were referred to ERCP for stone extraction, and (iv) normal pancreatobiliary tract. Reference standards for comparison were ERCP, surgery, a biopsy confirming malignancy, or the clinical course during follow up (at least 12 months) in cases without evidences of malignancy.
  
  
  RESULTS
  One hundred and seven patients (51 men; mean [SD] age 60.0 [15.5]) were included in the study. Final diagnoses were common bile duct (CBD) stone (n = 24), periampullary neoplasms (n = 46), others (n = 23) and no pathologic findings (n = 14). EUS determined the staging for clinical decision-making in 47 patients with neoplasms which showed that tumors in 34 patients (79.1%) were unresectable (advanced stage). After EUS, 47 patients (43.9%) did not require ERCP. The accuracy of EUS for the diagnosis of CBD stone and periampullary neoplasms were 96.3% and 99.1%, respectively.
  
  
  CONCLUSIONS
  EUS is a useful modality in cases of inconclusive MRI/MRCP indicating pancreatobiliary disorders.
authors.affiliation: Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran. setoodeh@ams.ac.ir
authors.forename: Rasoul
authors.initials: R
authors.lastname: Sotoudehmanesh
authors.forename: Morteza
authors.initials: M
authors.lastname: Khatibian
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Ghadir
authors.forename: Mohammad
authors.initials: M
authors.lastname: Bagheri
authors.forename: Amir Pejman
authors.initials: AP
authors.lastname: Hashemi-Taheri
authors.forename: Nahid
authors.initials: N
authors.lastname: Sedighi
authors.forename: Ali
authors.initials: A
authors.lastname: Ali-Asgari
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Zeinali
authors.forename: Shadi
authors.initials: S
authors.lastname: Shahraeeni
authors.forename: Shadi
authors.initials: S
authors.lastname: Kolahdoozan
mesh_terms: D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging*; D019160:Endosonography; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity