Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA.
Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Abdom Radiol (NY). 2019 Jul;44(7):2377-2383. doi: 10.1007/s00261-019-01975-8.
To determine the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) for detecting biliary and pancreatic abnormalities in a pediatric population, using endoscopic retrograde cholangiopancreatography (ERCP) as the reference standard.
Institutional review board approval with a waiver of informed consent was obtained for this retrospective investigation. Records from the Cincinnati Children's Hospital Medical Center, Division of Gastroenterology and Department of Radiology were used to identify patients aged ≤ 18 years who had undergone both ERCP and MRCP within a 4-week interval between January 2013 and May 2017. Biliary and pancreatic duct findings were documented for each modality to determine the diagnostic performance of MRCP (with 95% confidence intervals), using ERCP as the reference standard.
54 patients met inclusion criteria. Mean patient age at time of ERCP was 10.4 ± 4.9 years, and 25 (46%) were male. Mean interval between ERCP and MRCP was 11.2 ± 9.7 days. For detection of any abnormality (n = 99 ERCP findings), MRCP had a sensitivity of 76.8% (67.5-84.0%) and a positive predictive value (PPV) of 81.7% (72.7-88.3%). MRCP was 75.7% (59.9-86.6%) sensitive, with a PPV of 84.9% (69.1-93.4%) for biliary findings (n = 37) and 73.5% (59.7-83.8%) sensitive, with a PPV of 78.3% (64.4-87.7%) for pancreatic findings (n = 49). For pancreatobiliary abnormalities (n = 13), MRCP had a sensitivity of 92.3% (66.7-99.6%) and a PPV of 85.7% (60.1-97.5%).
In clinical practice, MRCP is moderately sensitive for biliary and pancreatic abnormalities, with false-negative and false-positive examinations being relatively common.
通过内镜逆行胰胆管造影术（ERCP）作为参考标准，确定磁共振胰胆管造影术（MRCP）在儿科人群中检测胆道和胰腺异常的诊断性能。
本回顾性研究获得了辛辛那提儿童医院医疗中心机构审查委员会的批准，并豁免了知情同意。使用辛辛那提儿童医院胃肠病学部和放射科的记录，确定了 2013 年 1 月至 2017 年 5 月期间，在 4 周内同时接受 ERCP 和 MRCP 的年龄≤18 岁的患者。记录每种方式的胆道和胰管发现，以确定以 ERCP 为参考标准的 MRCP（95%置信区间）的诊断性能。
54 名患者符合纳入标准。ERCP 时患者的平均年龄为 10.4±4.9 岁，25 名（46%）为男性。ERCP 和 MRCP 之间的平均间隔为 11.2±9.7 天。对于任何异常（n=99 个 ERCP 结果）的检测，MRCP 的敏感性为 76.8%（67.5-84.0%），阳性预测值（PPV）为 81.7%（72.7-88.3%）。MRCP 对胆道异常的敏感性为 75.7%（59.9-86.6%），PPV 为 84.9%（69.1-93.4%）（n=37），对胰腺异常的敏感性为 73.5%（59.7-83.8%），PPV 为 78.3%（64.4-87.7%）（n=49）。对于胰胆管异常（n=13），MRCP 的敏感性为 92.3%（66.7-99.6%），PPV 为 85.7%（60.1-97.5%）。
在临床实践中，MRCP 对胆道和胰腺异常具有中等敏感性，假阴性和假阳性检查相对常见。
