Ahrar Hossein, Jafarpishe Mohamad Saleh, Hekmatnia Ali, Solouki Reza, Emami Mohammad Hassan
Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Poursina Hakim Research Institute, Isfahan, Iran.
J Res Med Sci. 2014 Dec;19(12):1150-4.
Magnetic resonance cholangiography (MRC) has gained popularity for diagnosing primary sclerosing cholangitis (PSC). We determined the accuracy of MRC compared with endoscopic retrograde cholangiography (ERC) for diagnosing PSC.
This retrospective case-control study was conducted on patients referred to an outpatient gastroenterology clinic from 2001 to 2013. Patients with established diagnosis of PSC who had undergone MRC and ERC within a 6-month interval were included. Controls were selected from patients who had undergone imaging for reasons other than PSC evaluation. Disease outcome at the study time and liver biochemistry data at diagnosis and 1-year thereafter were retrieved. Diagnostic accuracy of MRC in comparison with ERC was evaluated.
A total of 46 definite PSC patients (age at diagnosis = 36.8 ± 11.6 years, 33 male) were found. Diagnostic imaging for PSC was ERC alone in 12, MRC alone in 23, and ERC plus MRC in 11 patients. Controls were 89 patients mostly with bile stones. The sensitivity, specificity, and positive and negative likelihood ratios of MRC was 90.9%, 95.5%, 20.23, and 0.10, respectively. Early PSC was found more frequently by MRC compared with ERC (30.4% vs. 8.3%, P = 0.146). No significant difference was found between imaging modalities with regards to patients' outcome (P = 0.786) or liver biochemistry at diagnosis or 1-year thereafter (P >0.05).
Starting diagnostic imaging for PSC with MRC seems better and may provide diagnosis of PSC at its earlier phase. Further studies with larger sample of patients and longer follow-ups are warranted.
磁共振胰胆管造影（MRC）在原发性硬化性胆管炎（PSC）的诊断中越来越受欢迎。我们确定了MRC与内镜逆行胰胆管造影（ERC）相比在诊断PSC方面的准确性。
本回顾性病例对照研究针对2001年至2013年转诊至门诊胃肠病诊所的患者进行。纳入在6个月内接受过MRC和ERC且确诊为PSC的患者。对照组选自因PSC评估以外的原因接受影像学检查的患者。检索研究时的疾病结局以及诊断时和此后1年的肝脏生化数据。评估MRC与ERC相比的诊断准确性。
共发现46例确诊的PSC患者（诊断时年龄=36.8±11.6岁，男性33例）。仅接受ERC进行PSC诊断性成像的患者有12例，仅接受MRC的有23例，接受ERC加MRC的有11例。对照组为89例主要患有胆结石的患者。MRC的敏感性、特异性、阳性和阴性似然比分别为90.9%、95.5%、20.23和0.10。与ERC相比，MRC更频繁地发现早期PSC（30.4%对8.3%，P=0.146）。在患者结局（P=0.786）或诊断时及此后1年的肝脏生化方面（P>0.05），成像方式之间未发现显著差异。
以MRC开始对PSC进行诊断性成像似乎更好，并且可能在PSC的早期阶段提供诊断。有必要对更多患者样本进行更大规模且随访时间更长的进一步研究。
