Department of Medicine II, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Department of Medicine A, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany.
Gut. 2023 Sep;72(9):1738-1744. doi: 10.1136/gutjnl-2021-326106. Epub 2023 Feb 24.
Changes of the pancreaticobiliary ducts herald disease. Magnetic resonance cholangiopancreatography (MRCP) allows accurate duct visualisation. Data on reliable upper reference ranges are missing.
Cross-sectional whole body MRI data from the population-based Study of Health in Pomerania were analysed. The width of the common bile duct (CBD) and the pancreatic duct (PD) was determined. We aimed to describe the distribution of physiological duct diameters on MRCP in a population of healthy subjects and to identify factors influencing duct size.
After excluding pre-existing pancreaticobiliary conditions, CBD and PD diameters from 938 and 774 healthy individuals, respectively, showed a significant increase with age (p<0.0001) and exceeded the conventional upper reference limit of normal in 10.9% and 18.2%, respectively. Age-dependent upper reference limits of duct diameters were delineated with non-parametric quantile regression, defined as 95th percentile: for CBD up to 8 mm in subjects <65 years and up to 11 mm in subjects ≥65 years. For the PD reference diameters were up to 3 mm in subjects <65 years and up to 4 mm in subjects ≥65 years.
This is the first population-based study delineating age-adjusted upper reference limits of CBD and PD on MRCP. We showed that up to 18.2% of healthy volunteers would have needed diagnostic workup, if the conventional reference values were used. The utilisation of the adapted reference levels may help to avoid unnecessary investigations and thus to reduce healthcare expenditure and test-related adverse events.
胰胆管变化预示着疾病的发生。磁共振胆胰管成像（MRCP）可准确显示胆管。目前缺乏可靠的胆管参考范围数据。
对基于人群的波罗的海健康研究的横断面全身 MRI 数据进行分析。确定胆总管（CBD）和胰管（PD）的宽度。我们旨在描述健康受试者 MRCP 上生理胆管直径的分布，并确定影响胆管大小的因素。
在排除先前存在的胰胆管疾病后，938 名健康个体的 CBD 直径和 774 名健康个体的 PD 直径均显示出与年龄相关的显著增加（p<0.0001），分别有 10.9%和 18.2%超过了常规的正常上限。使用非参数分位数回归确定了与年龄相关的胆管直径上限参考值，定义为 95%分位数：对于 CBD，<65 岁的受试者上限为 8mm，≥65 岁的受试者上限为 11mm。对于 PD，<65 岁的受试者上限为 3mm，≥65 岁的受试者上限为 4mm。
这是第一项基于人群的研究，描绘了 MRCP 上 CBD 和 PD 的年龄调整上限参考值。我们表明，如果使用传统参考值，多达 18.2%的健康志愿者将需要进行诊断性检查。使用适应的参考水平可能有助于避免不必要的检查，从而减少医疗保健支出和与检查相关的不良事件。
