Hintze R E, Adler A, Veltzke W, Abou-Rebyeh H, Hammerstingl R, Vogl T, Felix R
Dept. of Internal Medicine and Gastroenterology, Humboldt University of Berlin, Germany.
Endoscopy. 1997 Mar;29(3):182-7. doi: 10.1055/s-2007-1004160.
The clinical importance of magnetic resonance cholangiopancreatography (MRCP) as a noninvasive diagnostic modality for investigation of the biliary tree and pancreatic duct system is under debate. Using endoscopic retrograde cholangiopancreatography (ERCP) as the gold standard, this study determined in a prospective, blinded fashion the sensitivity and further statistic values of MRCP findings for evaluation of the biliary and pancreatic tract.
Seventy-eight patients referred for ERCP were studied prospectively with MRCP and ERCP during a 12-month period. All images were interpreted on a blinded basis by two radiologists. Any dilations, strictures, and intraductal abnormalities were recorded and correlated with the clinical diagnoses.
MRCP images of diagnostic quality were obtained in 76 of the 78 patients (97%). Magnetic resonance cholangiography (MRC) showed sensitivities (and positive predictive values) of 71% (62%) for recognition of normal bile ducts, 83% (91%) for recognition of dilation, 85% (100%) for recognition of strictures, 77% (91%) for correct stricture location, and 80% (100%) for diagnosing bile duct calculi. In addition, the sensitivity of MRC in classifying benign and malignant strictures was 50% and 80%, respectively. The statistical values (sensitivity and positive predictive value) for magnetic resonance pancreatography findings were determined for the recognition of normal pancreatic ducts (33% and 50%), recognition of dilation (62% and 100%), recognition of strictures (76% and 87%) and correct location (66% and 100%), diagnosis of benign strictures (87% and 87%) and malignant strictures (60% and 75%), and for diagnosing pancreatic duct stones (60% and 100%).
MRCP is capable of providing diagnostic information equivalent to ERCP in many patients, and should be applied whenever established techniques provide no results, or inadequate results.
磁共振胰胆管造影（MRCP）作为一种用于检查胆管和胰管系统的非侵入性诊断方法，其临床重要性仍存在争议。本研究以前瞻性、盲法的方式，以内镜逆行胰胆管造影（ERCP）作为金标准，确定了MRCP检查结果对评估胆管和胰管的敏感性及其他统计学值。
在12个月期间，对78例接受ERCP检查的患者进行了MRCP和ERCP的前瞻性研究。所有图像均由两位放射科医生在盲法基础上进行解读。记录任何扩张、狭窄及导管内异常情况，并与临床诊断进行关联。
78例患者中有76例（97%）获得了诊断质量的MRCP图像。磁共振胆管造影（MRC）对正常胆管识别的敏感性（及阳性预测值）为71%（62%），对扩张识别的敏感性为83%（91%），对狭窄识别的敏感性为85%（100%），对狭窄正确定位的敏感性为77%（91%），对胆管结石诊断的敏感性为80%（100%）。此外，MRC对良性和恶性狭窄分类的敏感性分别为50%和80%。确定了磁共振胰管造影检查结果对正常胰管识别（33%和50%）、扩张识别（62%和100%）、狭窄识别（76%和87%）及正确定位（66%和100%）、良性狭窄诊断（87%和87%）、恶性狭窄诊断（60%和75%）以及胰管结石诊断（60%和100%）的统计学值（敏感性和阳性预测值）。
MRCP能够为许多患者提供与ERCP相当的诊断信息，并且在现有技术无法得出结果或结果不充分时均应采用。
