title: Comparative evaluation of magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography and endoscopic ultrasound in the diagnosis of portal cavernoma cholangiopathy.
abstract: BACKGROUND
  Magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography (MRCP/MRSPV) is now the investigation of choice for the diagnosis of portal cavernoma cholangiopathy (PCC). Endoscopic ultrasound (EUS) is an emerging diagnostic modality for the diagnosis of PCC and may be better than MRCP/MRSPV to see the layer-wise localization of varices and to differentiate between varices, stone, and malignancy.
  
  
  METHODS
  Retrospective data of 50 patients of extrahepatic portal vein obstruction (EHPVO) were collected, and comparison between MRCP/MRSPV and EUS was done for the diagnosis of PCC.
  
  
  RESULTS
  Out of 50 patients, 56 % (28) were males, 44 % (22) females, and 24 % (12) symptomatic. Biliary changes were seen in 40 patients (80 %). Epicholedochal collateral (EPEC) was detected in 48 % and 20 % in MRCP/MRSPV and EUS, respectively. Perforators (PER) and intracholedochal collateral (ICC) were better seen with EUS (72 % and 48 %) as compared to MRCP/MRSPV (0 % and 8 %), and p-values were significant (<0.05). EUS has a sensitivity of 33.33 % and a specificity of 92.31 % for EPEC. Portal cavernoma (PC) and collateral at porta (CP), paracholedochal collateral (PAC), perisplenic (PS) and peripancreatic collateral (PPC), pericholedochal collateral (PEC), intrahepatic biliary radical dilatation (IHBRD), perigallbladder collateral (PG), common bile duct dilatation (CBDD) and common hepatic duct dilatation (CHDD), common bile duct stricture (CBDS), and retropancreatic collateral (RPC) were comparable between the two modalities.
  
  
  CONCLUSIONS
  EUS detected PER and ICC better than MRCP/MRSPV, while MRCP/MRSPV was more sensitive for detecting EPEC.
authors.affiliation: Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
authors.forename: Gyan Prakash
authors.initials: GP
authors.lastname: Rai
authors.affiliation: Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India. dr_nijhawan@yahoo.com.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Nijhawan
authors.affiliation: Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
authors.forename: M P
authors.initials: MP
authors.lastname: Madhu
authors.affiliation: Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
authors.forename: Shyam Sundar
authors.initials: SS
authors.lastname: Sharma
authors.affiliation: Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Pokharna
mesh_terms: D000293:Adolescent; D000328:Adult; D001649:Bile Duct Diseases / Q000175:diagnosis*; D017734:Bile Ducts, Extrahepatic; D002648:Child; D049448:Cholangiopancreatography, Magnetic Resonance; D019160:Endosonography; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000002:abnormalities*; D011172:Portography; D012189:Retrospective Studies; D055815:Young Adult
keywords: Endoscopic ultrasound; Magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography; Paracholedochal collateral; Pericholedochal collateral; Portal cavernoma cholangiopathy