Extrahepatic biliary diseases: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatography.

Abstract

PURPOSE: To assess the diagnostic value of three-dimensional (3D) magnetic resonance (MR) cholangiopancreatography versus endoscopic retrograde cholangiopancreatography (ERCP) in various pancreaticobiliary diseases. MATERIALS AND METHODS: Forty-six consecutive adult patients suspected to have extrahepatic biliary disease were examined. Breath-hold 3D steady-state free-precession MR cholangiopancreatography was performed. Correct determination of the level of biliary obstruction (n = 23) and of the cause of lesions (n = 46) was independently assessed with both MR cholangiopancreatography and ERCP by two readers blinded to the diagnosis. Results were compared. The overall diagnostic accuracies of both modalities also were compared. RESULTS: Level of obstruction was accurate in 91% (21 of 23) with MR cholangiopancreatography and in 83% (19 of 23) with ERCP (P > .05). The sensitivity, specificity, and accuracy in distinguishing malignant from benign lesions were 81%, 92%, and 87%, respectively, for MR cholangiopancreatography and 71%, 92%, and 83%, respectively, for ERCP. However, the differences were not significant (P > .05). The overall diagnostic accuracies of MR cholangiopancreatography and ERCP were 72% and 61% (P > .05), respectively. CONCLUSION: 3D MR cholangiopancreatography not only is fast and reliable in evaluating the extrahepatic bile duct, but also offers a diagnostic value equivalent to that of ERCP.