Limitation of Magnetic Resonance Cholangiopancreatography in The Evaluation of Biliary Tree Pathology,
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- Category: Vol. 84, March 2016
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Limitation of Magnetic Resonance Cholangiopancreatography in The Evaluation of Biliary Tree Pathology, GHADA ABDULMONAEM, HOSAM N. AL-MASSRY, ENASS M. KHATTAB and MANSOUR M. MORSY
Abstract
Objective: Many pitfalls have been encountered in eval-uation of Magnetic Resonance Cholangiopancreatography (MRCP) images that alter its diagnostic accuracy, the awareness of these pitfalls help in avoiding misinterpretation of images.
Patients and Methods: From the 234 patients, this retro-spective study including 24 patients with false MRCP diagnosis compared with Endoscopic Retrograde Cholangiopancreatog-raphy ERCP, MRCP examinations were performed using a multi section turbo spin-echo sequence. The data obtained from Maximum Intensity Projection (MIP) image was corre-lated with the source image and other MRI sequences.
Results: Overall sensitivity, specificity, positive, negative predictive values and accuracy of MRCP in detecting biliary obstruction compared with ERCP measured 93%, 87%, 92% and 89% and 90% respectively. From the 234 patients, there are 24 (9%) misdiagnosed cases by MRCP as false positive n=17 (71%) and false negative n=7 (29%) cases. According to underlying cause of misdiagnosis those related to extraductal factor was accounted for most of recorded pitfalls resulting in 9 (37%) cases, followed by the technical factors 7 (29%) cases, anatomical variants that simulates pathology 6 cases (25%) and factors related to intraductal cause in 2 (8%) cases.
Conclusion: MRCP was accurate non invasive technique for evaluation of biliary pathology with diagnostic accuracy comparable to ERCP, the understanding of causes resulting in misinterpretation help in increasing its accuracy.