Pancreaticobiliary diseases - Comparison of 2D single-shot turbo spin-echoMR cholangiopancreatography with endoscopic retrograde cholangiopancreatography

Purpose: To compare the diagnostic value of MR cholangiopancreatography (MR CP) to that of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of various obstructive and nonobstructive pancreaticobiliary dis eases. Material and Methods: We retrospectively reviewed 153 patients who had unde rgone both MRCP and ERCP. Breath-hold, heavily T2-weighted images using 2D single-shot turbo spin-echo technique were obtained. MRCP and ERCP results were correlated with the final clinical diagnoses. Accuracy of MRCP and ERC P in the diagnosis of pancreaticobiliary diseases, detecting the cause and site of biliary obstruction, if present, and distinguishing malignant from benign cause of obstruction were compared. Results: Success rates of MRCP and ERCP were 98.7% and 89.5%, respectively. The accuracy of MRCP and ERCP in detecting the site of biliary obstruction was 89.7% and 96.2%, and in detecting the cause of biliary obstruction 69. 2% and 71.8%, respectively. The sensitivity, specificity and likelihood rat ios for positive and negative tests for MRCP and ERCP in distinguishing mal ignant biliary obstruction from benign causes were 86.4%, 82.4%, 4.9, 0.2 a nd 88.6%, 94.1%, 15.1, 0.1, respectively. Concordance between the two tests was 91% (kappa coefficient 0.82, standard error of kappa 0.113, p<0.001). In the group of nonobstructive biliary diseases, accuracy of MRCP and ERCP in detecting cholecystolithiasis were 100% and 73.7%, and in detecting panc reatitis 57% and 14%, respectively. Conclusion. 2D single-shot turbo spin-echo MRCP can be performed as a compl ement to ERCP and can replace ERCP in high-risk patients and in case of uns uccessful cannulation.