MAGNETIC-RESONANCE CHOLANGIOGRAPHY - COMPARISON WITH ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

Background & Aims: Magnetic resonance cholangiography (MRC) is a nonin vasive diagnostic modality capable of producing high-quality images of the biliary tree. The purpose of this study was to determine in a pro spective, blinded fashion the sensitivity and specificity of three-dim ensional fast spin-echo (30 FSE) MRC for the evaluation of biliary tra ct abnormalities. Methods: Forty-six patients referred for elective di rect cholangiography (45 endoscopic retrograde cholangiopancreatograph y and 1 percutaneous transhepatic cholangiography) were studied prospe ctively with 30 FSE MRC during a 1-year period. All images were interp reted blindly by two radiologists. The presence of dilatation, strictu res, and intraductal abnormalities was recorded. Sensitivity and speci ficity of 30 FSE MRC were determined using findings on direct cholangi ography as the gold standard. Results: MRC images of diagnostic qualit y were obtained in 44 (95.7%) of the patients. Sensitivity for the det ection of bile duct dilatation (n = 27), biliary strictures (n = 10), and intraductal abnormalities (n = 7) was 96.3%, 90%, and 100%, respec tively. In addition, the MRC showed 16 of 17 patients with normal bile ducts (specificity, 94.1%). Conclusions: MRC has a very high sensitiv ity and specificity in the evaluation of the biliary tract. Based on t hese data, we believe that the efficacy of MRC using 30 FSE is suffici ent to warrant its use in the routine diagnosis of biliary tract disea se.