Vaca-Montenegro F, Guerrero-Avendaño G, Amezcua-Herrera C

Language: Spanish
References: 14
Page: 7-13
PDF size: 704.34 Kb.

ABSTRACT

Introduction. Diseases of the biliary tract and the upper abdomen are highly varied; consequently, it is important to have accurate clinical information on patients and the elements of the diagnostic presumption as guidelines for interpretation of image studies. Magnetic resonance cholangiopancreatography (MRCP) uses hydrography (of static fluids) as a diagnostic method. The goal of this analysis is to determine the percentage of certainty of clinical diagnoses and its correlation with findings by this imaging method in patients referred to the Department of Magnetic Resonance of the Hospital General de México.
Materials and method. We conducted a retrospective study of 208 patients (84 men and 124 women) between the ages of 13 and 91 years (average 49 years) with various clinical diagnoses of the biliary tract and upper abdomen, who underwent magnetic resonance cholangiopancreatography using the non breath-hold, heavily T2 weighted, and respiratory-triggered turbo spin-echo sequences. A Magnetom Avanto, Siemens^® 1.5 Tesla resonator was used.
Results. The clinical diagnoses varied widely. Most were single diagnoses, other studies produced two diagnoses, and several reported icteric syndrome. In 153 patients MRCP was consistent with the clinical diagnoses, but in 55 patients it did not coincide.
Discussion. Jaundice is the primary sign of biliary tract disorders (in different obstructive processes) and clinical information is fundamental to guide the radiologist in interpreting MRCP studies. In some patients, it would be extremely helpful to have more specific clinical data, because MRCP is useful not only in evaluating the biliary tract but also for other diseases of that anatomic region.
Conclusion.The clinical information the radiologist receives should be more extensive and detailed in referral diagnoses because it will permit a better clinico-radiological correlation for patients’ benefit and help achieve substantial savings in healthcare institutions.

REFERENCES

1. Wallner BK, Schumacker KA, Weidenmaier W, Freicrich JM. DIlated Biliary tract: evaluation with MR cholangiography with a T2-weighted contrast-enhanced fast sequence. Radiology 1991; 181: 805-808.

2. Hemant T. Patel, MD, DNB, DMRE, Ankur J. Shah, MD, Shikha R. Khandelwal, MR Cholangiopancreatography, Radiographics 2009; 29: 1689-1706.

3. Castellon CJ, et al. Coledocolitiasis: Indicaciones colangiopancreatografia retrograda endoscopica y colangioresonancia magnética. Cir Esp 2002; 71(6): 314-318.

4. Romagnuolo J, Bardou M, Rahme E, Joseph L, Reinhold C. Magnetic Resonance Cholangiopancretography: A meta- Analisis of test performance In Suspected Biliary Disease. Annals of Internal Medicine 2003; 139:547-557.

5. Tanner AR, Dwarakanath AD, Tait NP. The potential impact of highquality MRI of the biliary tree on ERCP workload. Eur J Gastroenterol Hepatol 2000;12:773-6.

6. Vitellas KM, Keogan MT, Freed KS et al. Radiologic Manifestations of Sclerosing Cholangitis with emphasis on MR Cholangiopancreatography. Radiographics 2000; 20:959-975.

7. Borlak J. Molecular diagnosis of a familial nonhemolytic hyperbilirrubinemia (Gilbert´s syndrome) in healthy subjects. Hepatol 2000;32:792.

8. Yusuhn K, Jeong M, Seung H, Joon K, Byung I, Intrahepatic Mass-forming Cholangiocarcinoma: Enhancement Patterns on Gadoxetic Acid–enhanced MR Images, Radiology 2012, 264:3, 751-760.

9. Jaroslaw N. Tkacz, MD, Stephan A. Anderson, Soto J, MD, MR Imaging in Gastrointestinal Emergencies, Radiographics 2009; 29:1767–1780.

10. Yuji W, Masako D, Takayoshi I, Yoshiki A, Akira O, Kazushige O, Shinji K, Yoshiro D, Diagnostic Pitfalls of MR Cholangiopancreatography in the Evaluation of the Biliary Tract and Gallbladder, Radiolographics 1999;19:415-429.

11. Demartines N, Eisner L, Schnabel K, Fried R, Zuber M, Harder F. Evaluation of magnetic resonance cholangiography in the management of bile duct stones, Arch Surgery 2000; 135: 148-52.

12. Green RM, et al. AGA technical review on the evaluation of liver chemestry tests. Gastroenterol 2002;123:1367.

13. Huibregtese K. Complications of endoscopic sphincterotomy and their prevention (editorial). N Engl J Med 1996; 335: 961-3.

14. Taylor AC, Little AF, Hennessy OF, Banting SW, Smith PJ, Desmond PV. Prospective assessment of magnetic resonance cholangiopancreatography for noninvasive imaging of biliary tree. Gastrointest Endosc 2002; 55: 17-22.