Published online Dec 15, 2003. doi: 10.3748/wjg.v9.i12.2824
Revised: May 23, 2003
Accepted: June 4, 2003
Published online: December 15, 2003
AIM: To evaluate the clinical value of various imageological methods in diagnosing the pancreato-biliary diseases and to seek the optimal procedure.
METHODS: Eighty-two cases of pancreato-biliary diseases confirmed by surgery and pathology were analyzed. There were 38 cases of cholelithiasis, 34 cases of pancreato-biliary tumors and 10 other cases. The imageological methods included B-US, CT, ERCP, PTC, cross-sectional MRI and MR cholangiopancreatography (MRCP).
RESULTS: The accuracy rate of MRCP in detecting the location of pancreato-biliary obstruction was 100%. In differentiating malignant from benign obstruction, the sensitivity of the combination of MRCP and cross-sectional MRI was 82.3%, the specificity was 93.8%, and the accuracy rate was 89.0%. The accuracy rate for determining the nature of obstruction was 87.8%, which was superior to that of B-US (P = 0.0000) and CT (P = 0.0330), but there was no significant difference between direct cholangiopancreatography and the combination of MRCP and conventional MRI (P = 0.6666).
CONCLUSION: In most cases, MRCP can substitute direct cholangiopancreatography for diagnosis. The combination of MRCP and cross-sectional MRI should be considered as an important means in diagnosing the pancreato-biliary diseases, pre-operative assessment and post-operative follow-ups.