Dissociation in the Sensitivity of Magnetic Resonance Cholangiopancreatography in the Diagnosis of Biliary and Pancreatic Diseases

Abstract

Purpose: Magnetic resonance cholangiopanreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are the two currently available important tools in the diagnosis of pancreatobiliary diseases. The aim of this study was to examine the sensitivity of MRCP in the diagnosis of pancreatobiliary diseases using ERCP as the gold standard. Methods: We studied all patients who had ERCP and also MRCP at Emory University Hospital from January 1st 2002 to January 20th 2007. Those who had MRCP beyond 3 months of ERCP, who had liver transplant or biliary surgery between those two tests, and who had incomplete or suboptimal ERCP or MRCP were excluded from the study. We compared the diagnosis suggested by those two tests in eligible patients. Results: 184 patients met the enrollment criteria during the study period. Of those, 136 had abnormalities mainly in the biliary system, and 48 had abnormalities mainly in the pancreas in ERCP. In the 136 patients who had biliary abnormalities, MRCP had the correct diagnosis as ERCP in 111 patients (82% of 136) and incorrect diagnosis in 25 patients (18% of 136). In contrast, in the 48 patients who had pancreatic abnormalities, MRCP had the correct diagnosis as ERCP in 46 patients (96% of 37) and incorrect diagnosis in 2 patients (4% of 48). The dissociation of the sensitivity of MRCP in diagnosis of the biliary diseases and the pancreatic diseases is statistically significant (P < 0.05). Conclusion: In this retrospective study, MRCP had more accuracy in the diagnosis of pancreatic diseases than that of biliary diseases when ERCP was used as the gold standard.