The researchers prospectively assessed the accuracy of magnetic resonance cholangiopancreatography (MRCP) for noninvasive imaging of the biliary tree.
They reported their results in the January 2002 issue of Gastrointestinal Endoscopy.
A total of 146 consecutive patients, who were referred to a teaching hospital for ERCP, were eligible for study entry.
MRCP was performed within 24 hours before ERCP. MRCP findings were compared with ERCP findings or, when the initial ERCP was unsuccessful, with results of repeat ERCP, percutaneous transhepatic cholangiography, or surgery.
The patients underwent 149 ERCP/MRCP procedures, of which 129 were evaluable with successful MRCP and ERCP, or an ERCP-equivalent study.
|Diagnosing choledocholithiasis with MRCP:|
| Gastrointestinal Endoscopy |
Diagnoses included choledocholithiasis in 46 and biliary stricture in 12 patients.
The sensitivity, specificity, positive, and negative predictive values for MRCP in the diagnosis of choledocholithiasis were 98%, 89%, 84%, and 97%, respectively.
The team found that all 12 strictures were diagnosed by MRCP (sensitivity 100%, specificity 99%).
Andrew C. F. Taylor, of St. Vincent's Hospital, Melbourne, said on behalf of his colleagues, "MRCP is an accurate, noninvasive alternative to ERCP for imaging the biliary tree.
"Choledocholithiasis and biliary strictures can be reliably diagnosed or excluded by MRCP."
"MRCP should be used increasingly in patients with suspected biliary obstruction to select those who require a therapeutic procedure," he concluded.