MRCP vs ERCP, journal article

[Guest guest]

This may be of interest, in relation to our recent discussion on whether

MRCP was as effective diagnositically.

Sorry, I don't have the original site any more. I found it at work a couple

weeks ago, and forwarded to myself at home, but then didn't log on for

awhile.

Pam (mom to Quantell, 10, dx 1996; status 2b on the transplant list, but

with a hold pending a cardiac cath)

Primary sclerosing cholangitis: evaluation with MR cholangiography-A

case-control study. [in Process Citation]

Radiology 2000 Apr;215(1):71-80 (ISSN: 0033-8419)

Fulcher AS; MA; lin KJ; Shiffman ML; Sterling RK; Luketic VA;

Sanyal AJ

Department of Radiology (A.S.F., M.A.T.) and the Hepatology Section (K.J.F.,

M.L.S., R.K.S., V.A.C.L., A.J.S.), Medical College of Virginia of Virginia

Commonwealth University, 401 N 12th St, Main Hospital, 3rd Fl, Rm 3-415,

Richmond, VA 23298.

PURPOSE: To determine the accuracy of magnetic resonance (MR)

cholangiography for detection of primary sclerosing cholangitis (PSC) and

localization of PSC in the biliary tract.

MATERIALS AND METHODS: In a prospective case-control study involving 102

patients, the MR cholangiograms obtained in 34 patients with PSC established

with endoscopic retrograde cholangiopancreatography (ERCP) were compared

with the MR cholangiograms obtained in 68 age-matched control patients with

hepatobiliary diseases other than PSC. Two abdominal radiologists conducted

an independent, blinded random review of the MR cholangiograms to assess for

the presence or absence of PSC and determine the location of PSC in the

biliary tract, and then compared the findings with those at ERCP.

RESULTS: MR cholangiography was found to be accurate in detecting PSC and in

defining the extent of disease. In the detection of PSC, the sensitivities

were 88% and 85%; specificities, 97% and 92%; positive predictive values,

94% and 85%; and negative predictive values, 94% and 93% for readers 1 and

2, respectively. Interobserver agreement was excellent (kappa = 0.79). In

the localization of extrahepatic PSC, the sensitivities were 83% and 89%;

and specificities, 83% and 83% for readers 1 and 2, respectively.

Interobserver agreement was good (kappa = 0.62). In the localization of

intrahepatic PSC, the sensitivity was 87% for both readers; interobserver

agreement was good (kappa = 0.71).

CONCLUSION: MR cholangiography enables accurate detection and localization

of PSC.