Use of Magnetic Resonance Cholangiopancreatography in Clinical Practice: Not as Good as We Once Thought
Use of Magnetic Resonance Cholangiopancreatography in Clinical Practice: Not as Good as We Once Thought
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DOI：
10.1016/j.jamcollsurg.2015.01.060
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发表时间：
2015-07-01
影响因子：
5.2
通讯作者：
Brown, Carlos V. R.
中科院分区：
文献类型：
--
作者：
Aydelotte, Jayson D.;Ali, Jawad;Brown, Carlos V. R.
背景技术背景：磁共振胰胆管造影（MRCP）被认为是一个有用的工具，以评估胆道系统和胰腺的结石，肿瘤，或损伤的韧性系统。本研究的目的是比较的准确性MRCP的金标准，内镜逆行胰胆管造影术（ERCP），在我们institution.Study设计：我们进行了回顾性分析，所有MRCP后ERCP（后续ERCP）在一个单一的机构超过6年的时间。将MRCP检查结果与后续ERCP检查结果进行比较。研究分为2个主要分类：被怀疑胆总管结石（结石病）和恶性狭窄或胆管损伤（非结石病）的关注正在进行测试的患者进行测试。结果：共有81例患者MRCP和后续ERCP在这段时间。36例患者在MRCP和ERCP上对胆总管系统结石有阳性发现，14例患者在MRCP和随后的ERCP上对胆总管肿块和狭窄有阳性发现。3例患者的MRCP和ERCP结果均显示胰管异常。MRCP诊断乳腺癌的特异性和阳性预测值分别为94%和98%。然而，28例患者中有13例在MRCP正常后的ERCP上发现了病变。敏感性和阴性预测值分别为80%和54%，respectively.CONCLUSIONS：磁共振胰胆管造影术是没有用的管理算法的结石或非结石性疾病的胆道系统或胰腺。应放弃将其作为胆道病理检查的诊断工具。(C)2015年美国外科医生学会
BACKGROUND: Magnetic resonance cholangiopancreatography (MRCP) is believed to be a useful tool to evaluate the biliary tree and pancreas for stones, tumors, or injuries to the ductile system. The purpose of this study was to compare the accuracy of MRCP to the gold standard, endoscopic retrograde cholangiopancreatography (ERCP), in our institution.STUDY DESIGN: We performed a retrospective review of all MRCP followed by ERCP (follow-on ERCP) at a single institution over a 6-year period. Exam findings from MRCP were compared with findings on the follow-on ERCP and compared. Studies were grouped into 2 main classifications: tests being performed for patients with suspected choledocholithiasis (stone disease) and tests being performed for concerns of malignant strictures or duct injuries (non-stone disease).RESULTS: A total of 81 patients had MRCPs and follow-on ERCPs in this time period. Thirty-six patients had positive findings on MRCP and ERCP for stones in the common duct system, and 14 patients had positive findings on MRCP and subsequent ERCP for masses and strictures of the common duct. Three patients had positive MRCP and ERCP findings for pancreatic duct abnormalities. The specificity and positive predictive value of MRCP were 94% and 98%, respectively. However, 13 of 28 patients had lesions identified on ERCP after a normal MRCP. The sensitivity and negative predictive value were 80% and 54%, respectively.CONCLUSIONS: Magnetic resonance cholangiopancreatography was not useful in the management algorithm of either stone or non-stone disease of the biliary tree or pancreas. It should be abandoned as a diagnostic tool for work-up of biliary duct pathology. (C) 2015 by the American College of Surgeons