THE USE OF MAGNETIC RESONANCE CHOLANGIOGRAPHY IN THE DIAGNOSIS OF OBSTRUCTIVE BILIARY DISEASES

Abstract

Aims: The aim of this prospective study was to assess the diagnostic accuracy of MRCP and to determine whether MRCP may help to prevent unnecessary interventional procedures.

Background: In the evaluation of patients with suspected biliary obstruction ultrasonography and computed tomography are sometimes not enough to determine the obstruction level and etiology. Endoscopic retrograde cholangiopancreaticography and percutaneous transhepatic cholangiography mostly provides the diagnosis of biliary obstructive lesion but they are invasive and mostly depend on the experience of the surgeon. The value of magnetic resonance cholangiopancreatography (MRCP) is under debate.

Methods: Between April 1997 and December 2000, magnetic resonance cholangiography was performed on 78 patients suspected to have biliary obstruction after clinical examination and laboratory findings. In all the patients the magnetic resonance cholangiography results have been compared with the direct cholangiography (ERCP,PTC), surgical exploration or clinical follow-up results.

Results: In 53 of 78 patients biliary obstruction was diagnosed with direct cholangiogrphy and operative findings. In the remaining 25 patients no pathology was found to cause biliary obstruction. Magnetic resonance cholangiography gave correct results in 50 of 53 patients with biliary obstruction (sensitivity 94.34%) and in 23 of 25 patients without biliary obstruction (spesificity 92%).

Conclusion: In biliary obstructive diseases, for the correct diagnosis of obstruction level and etiology, magnetic resonance cholangiography gave approximotely the same results with the results obtained by direct cholangiography. Magnetic resonance cholangiography is useful in the selection of patients that will benefit from therapeutic cholangiography. Magnetic resonance cholangiography also helps to reduce the unnecessary invasive methods.