A prospective comparison of magnetic resonance cholangiopancreatography with endoscopic retrograde cholangiopancreatography in the evaluation of patients with suspected biliary tract disease

AIM: To determine the diagnostic accuracy of magnetic resonance cholangiopa ncreatography (MRCP) compared with direct cholangiography in the detection of biliary tract disease. PATIENTS AND METHODS: MRCP was performed in 100 patients in whom direct cho langiographic correlation (ERCP, n = 98; PTC, n = 9; intraoperative cholang iography, n = 3) was available for comparison. The MRCP examinations were p erformed using a two-dimensional multi-slice, fast spin echo (FSE) techniqu e and a local surface coil. The diagnoses at direct cholangiography were ch oledocholithiasis in 30 patients, benign and malignant strictures in 28 pat ients and normal bile ducts in 42 patients. The nature of the strictures (b enign, n = 2; tumour, n = 18; lymphnode recurrence, n = 3; unknown histolog y, n = 5) was determined by one or more of the following procedures: surger y (n = 8), biopsy (n = 15), cytology (n = 6) and cross-sectional imaging/fo llow-up findings (n = 3), RESULTS: MRCP diagnosed choledocholithiasis with a sensitivity of 93%, spec ificity of 99% and accuracy of 97%, It resulted in two false-negative and o ne false-positive findings when compared with direct cholangiography, MRCP accurately diagnosed the presence and level of strictures in all patients. The overall sensitivity, specificity and accuracy of MRCP in the detection of bile duct lesions were 97%, 98% and 97%, respectively. CONCLUSION: MRCP has a high diagnostic accuracy when compared with direct c holangiography in the detection of bile duct disease.