Chang Yun Jung, Kim Jae Seon, Kim Hyoung Seuk, Kim Myung Gyu, Lee Ji Yeon, Seo Yeon Seok, Kim Cheol Hyun, Kim Jin Yong, Yeon Jong Eun, Park Jong-Jae, Byun Kwan Soo, Bak Young-Tae, Lee Chang Hong
Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2006 Apr;47(4):306-11.
BACKGROUND/AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is an operator-dependent procedure and has significant procedure-related morbidity and mortality. Magnetic resonance cholangiopancreatography (MRCP) is a safe noninvasive method for pancreatobiliary imaging. The aims of this study were to evaluate the potential impact of MRCP on performing ERCP and to evaluate the decision-making value of MRCP in patients suspicious for pancreatobiliary diseases.
Two hundreds twelve patients (M:F 108:104, mean age 59.3 +/- 13.7) who underwent MRCP due to clinical or sonographic suggesting pancreatobiliary disease were included. We divided patients into four groups according to their presumptive diagnosis: biliary stone (group 1), biliary tumor (group 2), gallstone pancreatitis (group 3) and other biliary diseases (group 4).
Numbers of cases in group 1, 2, 3 and 4 were 145, 43, 17 and 7, respectively. In 144 cases (67.9%), ERCP was unnecessary and 76 cases (35.8%) required neither ERCP nor any other treatment. Thereafter, these cases were thought to be a patient group in whom the workload of performing ERCP could be reduced.
MRCP can reduce the number and efforts doing ERCP and is helpful in decision-making for the treatment of pancreatobiliary disease. Therefore, MRCP could be the primary diagnostic tool before choosing ERCP.
背景/目的：内镜逆行胰胆管造影术（ERCP）是一种依赖操作者的操作，且具有与操作相关的显著发病率和死亡率。磁共振胰胆管造影（MRCP）是一种用于胰胆成像的安全无创方法。本研究的目的是评估MRCP对实施ERCP的潜在影响，并评估MRCP在疑似胰胆疾病患者中的决策价值。
纳入212例因临床或超声提示胰胆疾病而接受MRCP检查的患者（男:女为108:104，平均年龄59.3±13.7岁）。我们根据患者的初步诊断将其分为四组：胆管结石（第1组）、胆管肿瘤（第2组）、胆石性胰腺炎（第3组）和其他胆管疾病（第4组）。
第1、2、3和4组的病例数分别为145、43、17和7例。在144例（67.9%）患者中，ERCP不必要，76例（35.8%）既不需要ERCP也不需要任何其他治疗。此后，这些病例被认为是一组可以减少ERCP操作工作量的患者群体。
MRCP可以减少ERCP的操作数量和工作量，并有助于胰胆疾病治疗的决策。因此，在选择ERCP之前，MRCP可以作为主要的诊断工具。
