A Comparative Study On The Value Of Magnetic Resonance Cholangiopancreatography And Endoscopic Retrograde Cholangiopancreatography In Diagnosing Bile Duct Obstruction

Purpose To compare the value of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing bile duct obstruction and to research the MRCP features of bile duct obstruction.Methods There were 40 patients who had no disorders in their digestive systems in the first group of subjects (group 1). The second group subjects (group 2) consisted of 132 patients with bile duct obstruction which were surgically and/or pathologically demonstrated. All subjects underwent routine MRI scans, and then underwent consecutively three kind sequences of different MRCP scans. Dynamic enhanced MR imaging were also performed in the subjects with suspected tumor in group 2. Within 48 hours after MRCP examinations, ERCP were performed in the subjects of group 2. The imaging results of all subjects were analyzed carefully, and the advantages and disadvantages of the three kind sequences of different MRCP and ERCP technique were compared. The diameters of the common bile ducts on the SSFSE single thick images in group 1 were measured. The comparative analysis were performed between the MRCP images and the surgical and pathological findings in group 2. The sensitivity, specificity and accuracy in diagnosing the causes of the bile duct obstructions with MRCP were obtained.Results1. No significant difference was found between the single thick slice and multi-slice SSFSE sequences in imaging the normal bile duct trees and the bile duct obstructions, and both of them were superior to 3DFSE sequence (p<0.05).2. The SSFSE sequence MRCP images combined with its raw images were superior to the SSFSE sequence MRCP images only in diagnosis of the bile duct obstructions (p<0.05).3. The MRCP images combined with routine MRI and dynamic enhanced MR images were superior to the SSFSE sequence MRCP images only in diagnosis of malignant bile duct obstructions (p<0.05).4. No significant difference was found between the mean diameter of normal common bile ducts measured on the MRCP images (5.28±0.83mm) in the group 1 and that measured by ultrasonograph and ERCP in the literatures(p>.05?).5. The accuracy of the bile duct obstruction locations diagnosed by the MRCP images was 100%.6. The accuracy of the bile duct obstruction causes diagnosed by the MRCP images was 84.9%, the accuracy of that diagnosed by the MRCP images combined with routine MR images was 93.9%,and the accuracy of that diagnosed by the ERCP was 86.4%. ConclusionMRCP play an important role in the diagnosis of the bile duct obstructions and can take the place of ERCP.