A PROSPECTIVE EVALUATION OF MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH SUSPECTED BILE-DUCT OBSTRUCTION

Background-The value of magnetic resonance cholangiopancreatography (M RCP) is under debate. Aims-To assess the diagnostic accuracy of MRCP a nd endoscopic retrograde cholangiopancreatography (ERCP) and to determ ine whether MRCP may help to prevent unnecessary interventional proced ures. Methods-Eighty six patients with suspected common bile duct obst ruction who presented between January and December 1996 were enrolled. Twenty six were excluded due to anatomical reasons or because MRCP or ERCP could not be performed successfully. Results of MRCP were interp reted by two radiologists and a gastroenterologist unaware of clinical diagnosis. Final diagnosis was determined by ERCP and histopathologic al findings or a follow up of at least 12 months. Results-MRCP images of diagnostic quality were obtained in all 60 patients. Thirteen patie nts had a clear bile duct. Sensitivity and specificity for the detecti on of any abnormality (n=47) were 89% and 92%, and for the detection o f malignancy (n=27) 81% and 100%, respectively. These results were equ ivalent to the respective figures of ERCP (91% and 92% for any abnorma lity, and 93% and 94% for malignant diseases). Conclusions-MRCP is as sensitive as ERCP in the evaluation of bilary tract diseases. As the s pecificity of this noninvasive technique is close to 100%, MRCP may pr event inappropriate invasive explorations of the common bile duct and pancreatic duct.