A variety of imaging techniques are available to diagnose bile duct strictures; the most effective imaging technique, however, has not been established yet.
In this study, investigators from Germany evaluated techniques for diagnosing bile duct strictures. The team compared endoscopic retrograde cholangiopancreatography (ERCP), intraductal ultrasonography (IDUS), and magnetic resonance cholangiopancreatography (MRCP).
The team prospectively examined 33 patients with jaundice due to bile duct strictures by ERCP plus IDUS, and MRCP.
They aimed to assess diagnostic quality of imaging, complete presentation of the bile duct, and differentiation of malignant from benign lesions.
|Diagnostic image quality:|
-ERCP = 88%
-MRCP = 76%
|American Journal of Gastroenterology|
The team used surgical and histopathological correlations as the gold standard. These were available in all cases since all included patients underwent laparotomy.
The investigators found that the diagnostic image quality was 88% for ERCP and 76% for MRCP.
Complete presentation of the biliary tract was achieved in 94% of cases for ERCP and 82% for MRCP.
The team found that ERCP and MRCP allowed correct differentiation of malignant from benign lesions in 76% and 58% of cases, respectively.
They determined that by supplementing ERCP with IDUS, the accuracy of correct differentiation of malignant from benign lesions increased significantly to 88%.
Dr Dirk Domagk's team concluded, "Comparing ERCP with MRCP, we found adequate presentation of bile duct strictures in high imaging quality for both techniques".
"ERCP supplemented by IDUS gives more reliable and precise information about differentiation of malignant and benign lesions than MRCP alone without additional imaging sequences."