Özmen Evrim, Algın Oktay, Evrimler Şehnaz, Arslan Halil
Department of Radiology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
Department of Radiology, Atatürk Training and Research Hospital, Ankara, Turkey.
Balkan Med J. 2016 May;33(3):275-82. doi: 10.5152/balkanmedj.2016.140872. Epub 2016 May 1.
Contrast enhanced magnetic resonance cholangiography is a novel technique and promising method in demonstrating biliary tree anatomy and evaluating biliary disorders. However, to date, there are a limited number of studies that have focused on the impact of this technique.
We aimed to evaluate the additional role of contrast enhanced MR cholangiography (MRC) and compare contrast enhanced MRC with T2-weighted (w) magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of biliary disorders.
Diagnostic accuracy study.
The T2w-MRCP and contrast enhanced MRC sequences of 31 patients whose gold standard test results were available were scored visually for the existence of pathological findings with regard to any of the biliary diseases. Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) was used as the contrast agent. The correlation values were determined according to the statistical analysis made from those scores and the sensitivity, specificity and accuracy values of each sequence were detected as well.
We detected that the correlation values with gold standard methods of contrast enhanced MRC sequences were significantly higher than the ones of T2w-MRCP sequences. The correlation ratios of T2w-MRCP sequences were between 26 and 34%, while those for contrast enhanced MRC sequences were between 81 and 83% for the first reader and the correlation ratios of T2w-MRCP sequences were between 10 and 61%, whereas those of contrast enhanced MRC were between 79 and 81% for the second reader The mean sensitivity, specificity and accuracy values of T2w-MRCP sequences were 14.3-42.5%, 85-89.2% and 59.3-72.5%, respectively, while the mean sensitivity, specificity and accuracy values of contrast enhanced MRC sequences were 100%, 86.7% and 93.2-93.3%, respectively.
We suggest that obtaining of contrast enhanced MRC sequences in addition to the T2w-MRCP can be useful in the diagnosis of many diseases in relation with biliary tree.
对比增强磁共振胆胰管造影是一种在显示胆管系统解剖结构和评估胆道疾病方面的新技术和有前景的方法。然而，迄今为止，关注该技术影响的研究数量有限。
我们旨在评估对比增强磁共振胆胰管造影（MRC）的额外作用，并比较对比增强MRC与T2加权（w）磁共振胆胰管造影（MRCP）在胆道疾病诊断中的效果。
诊断准确性研究。
对31例有金标准检测结果的患者的T2w-MRCP和对比增强MRC序列进行视觉评分，以确定是否存在任何胆道疾病的病理表现。使用钆乙氧基苄基二乙三胺五乙酸（Gd-EOB-DTPA）作为造影剂。根据对这些评分进行的统计分析确定相关值，并检测每个序列的敏感性、特异性和准确性值。
我们发现对比增强MRC序列与金标准方法的相关值显著高于T2w-MRCP序列。对于第一位阅片者，T2w-MRCP序列的相关率在26%至34%之间，而对比增强MRC序列的相关率在81%至83%之间；对于第二位阅片者，T2w-MRCP序列的相关率在10%至61%之间，而对比增强MRC序列的相关率在79%至81%之间。T2w-MRCP序列的平均敏感性、特异性和准确性值分别为14.3%-42.5%、85%-89.2%和59.3%-72.5%，而对比增强MRC序列的平均敏感性、特异性和准确性值分别为100%、86.7%和93.2%-93.3%。
我们建议，除了T2w-MRCP外，获取对比增强MRC序列可能有助于诊断许多与胆管系统相关的疾病。
