Value Of Magnetic Resonance Cholangiopancreatography Research Articles

Value of magnetic resonance cholangiopancreatography in the evaluation of biliary obstruction

Background: Obstructive jaundice is a common clinical condition that causes many complications, especially septic shock. Magnetic resonance cholangiopancreatography (MRCP) plays an important role in determining the cause, extent, and complications of biliary obstruction. Purposes: To investigate the value of magnetic resonance cholangiopancreatography in the diagnosis of biliary obstruction. Materials and Methods: A descriptive cross-sectional study was conducted at Hue University of Medicine and Pharmacy Hospital from January 2019 to November 2022. Forty-four patients with biliary obstruction who underwent MRCP, and percutaneous transhepatic cholangiography (PTC, a step in the procedure of percutaneous transhepatic biliary drainage) were retrospectively analyzed. Results: The mean age was 62.75 ± 13.29 years. Male/female ratio was 1.3/1. The most common cause of obstruction was biliary malignancy (56,9%). Bilateral intrahepatic duct dilation (54.5%) and hilar obstruction (65.9%) were predominant. On MRCP, abrupt cut-off of the duct, irregular margin, and asymmetric biliary stricture. There was a good to very good concordance between MRCP and PTC in determining the site of dilatation, site of obstruction, and characteristics of biliary obstruction. Compared with PTC, MRCP had a sensitivity of 100% and a specificity of 89.5% in the evaluation of abrupt cut-off; a sensitivity of 90.5% and a specificity of 100% in detecting biliary stricture. Conclusion: MRCP is useful in a comprehensive evaluation of the biliary tract including anatomy and variations as well as site, degree, extent, etiologies, and complications of obstruction. MRCP should be included in the routine workup of patients with biliary obstruction who might be candidates for percutaneous biliary intervention. Key words: Biliary obstruction, magnetic resonance cholangiopancreatography, percutaneous transhepatic cholangiography, percutaneous transhepatic biliary drainage.

WTP3.12 Value of magnetic resonance cholangiopancreatography (MRCP) in acute gallstone pancreatitis

Abstract Aims Magnetic resonance cholangiopancreatography (MRCP) is commonly performed in acute pancreatitis to rule out bile duct stones (BDS). The aim of this study was to determine if MRCP is required to rule out BDS in patients admitted with gallstone pancreatitis (GS). Method A retrospective cohort study of all consecutive MRCPs in a single surgical unit from October 2021 to September 2022 was conducted. Patient demographics, laboratory results and MRCP result data was analysed. Patients with MRCP proven BDS were compared to those without. Results Sixty-one patients were identified, 39 (63.9%) were female. Median age was 62 years (IQR 45-75) and median Scottish Index of Multiple Deprivation was 4 (IQR 3-7). 55 (90.2%) MRCPs were inpatient and 30 (49.2%) were urgent requests. Median wait time for inpatient MRCP was 1 day (IQR 0.7-1.8) and 17.1 days (IQR 14.6-28.3) for outpatient requests. 14 (23%) patients had BDS proven on MRCP. Of these, 6 (42.8%) had evidence of dilated bile ducts on preceding imaging and 8 (57.1%) had hyperbilirubinaemia and raised alkaline phosphatase levels. Median wait time for MRCP for patients with BDS was 0.8 days (IQR 0.35-1.5) compared to 1.2 days (IQR 0.85-2.85) in MRCPs with no evidence of BDS. Conclusion We conclude that MRCP is not required for low-risk patients with acute gallstone pancreatitis. However, MRCP will be beneficial in patients with jaundice and preceding radiological evidence of ductal dilatation. Intraoperative cholangiography is recommended in patients who proceed to laparoscopic cholecystectomy where MRCP has not been performed.

Role of Magnetic Resonance Cholangiopancreatography in the Evaluation of Obstructive Jaundice

Background Magnetic Resonance Cholangiopancreatography is a reliable and highly sensitive imaging modality in the diagnosis of Obstructive jaundice.
 Objective To evaluate the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography as compared to Endoscopic Retrograde Cholangiopancreatography.
 Method A prospective, analytical study was conducted in the Department of Radiodiagnosis and Imaging at Dhulikhel Hospital between October 2018 and December 2020. Altogether 100 patients of all ages with obstructive jaundice undergoing Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography were included. The causes of obstructive jaundice as identified by Magnetic Resonance Cholangiopancreatography were compared to that of Endoscopic Retrograde Cholangiopancreatography considering Endoscopic Retrograde Cholangiopancreatography as gold standard for the diagnosis.
 Result Magnetic Resonance Cholangiopancreatography revealed choledocholithiasis in 60 (60%) patients, benign stricture – 14(14%), malignant stricture-11(11%), periampullary carcinoma in 8(8%) and normal study in 4(4%) patients. Endoscopic Retrograde Cholangiopancreatography showed choledocholithiasis in 59(59%) patients, strictures (benign in 13%, malignant in 10%), ascariasis in 3(3%) and normal findings in 5(5%) patients. The sensitivity, specificity, positive predictive value and negative predictive value of Magnetic Resonance Cholangiopancreatography in detecting choledocholithiasis were 96.6%, 92.3%, 95%, and 95%. The same values for benign strictures were 92.3%, 97.7%, 85.7% and 98.9%, whereas those for malignant strictures were 90.9%, 98.8%, 90.9% and 98.8%. All values were 100% for peri-ampullary carcinoma and ascariasis. Hence, Magnetic Resonance Cholangiopancreatography showed good accuracy for detecting causes of obstructive jaundice (p < 0.05) as compared to Endoscopic Retrograde Cholangiopancreatography.
 Conclusion Magnetic Resonance Cholangiopancreatography is an accurate, non-invasive technique in evaluation of obstructive jaundice and offers similar diagnostic value compared to Endoscopic Retrograde Cholangiopancreatography.

Biliary tract anatomical variance - the value of MRCP

SUMMARY Duplication of the common bile duct (CBD) is a rare congenital anomaly of the bile ducts that should be diagnosed prior to surgery in order to optimise management and prevent complications. We report a case of a patient presenting with choledocholithiasis and type Va duplicated extrahepatic bile duct that was missed on ultrasonography. The atypical course prompted further imaging with magnetic resonance cholangiopancreatography (MRCP), which identified the aberrant bile duct and assisted in safe preoperative and operative management. This case highlights the importance of accurate pre-interventional imaging and agrees with the reclassification of duplications of the CBD. Keywords: bile duct, extrahepatic, anomaly, duplicated, injury

Clinical Value of Preoperative MRCP of Cholelithiasis

To evaluate the value of Magnetic Resonance Cholangiopancreatography (MRCP), in the diagnosis of cholelithiasis, we randomly assigned 1000 patients with cholelithiasis from The First Hospital of Hohhot City since 2011. All the 1000 patients who were diagnosis of cholelithiasis in the clinical were given MRCP Preoperative. While 94.7% of the patients were examined with Preoperative Liver and gallbladder color Doppler ultrasound at least once, the remaining 5.3% were examined by CT of midsection. The software SPSS 13.0 was used to evaluate the difference of relevance ratio of cholelithiasis between color Doppler ultrasound and CT, as well as the relevance ratio of the variant Biliary system before operation. Among 1000 cases of cholelithiasis patients, patients with only Calculus of bile duct was 177, 676 cases of patients with only cholecystolithiasis, 185 cases of patients with both. The relevance ratio of cholelithiasis was 92.13% in Calculus of bile duct, and 87.50% among patients of cholecystolithiasis. The trail on the other hand analysis the clinical value of MRCP for the variant Biliary system before operation. MRCP is more suitable for the diagnosis of Calculus of bile duct and the judgement of variant Biliary system before operation, it can obviously reduce the occurrence of iatrogenic injury of biliary system, which made MRCP an important reference examination to the cholecystic preservation surgery.

MRCP before ERCP: the added value in the management of common bile duct stones.

Nowadays, some endoscopists believe that knowing a patient has common bile duct stones (CBDS) is not enough. An added value is required that allows the endoscopist performing the endoscopic retrograde cholangiopancreatography (ERCP) to obtain accurate and useful information in order to offer the best management of the condition. The added value of magnetic resonance cholangiopancreatography (MRCP) is attractive and can contribute to the success of the procedure.

Diagnostic value of magnetic resonance cholangiopancreatography to detect bile duct stones in acute biliary pancreatitis

ObjectivesThis study aims to evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in detecting common bile duct (CBD) stones in acute biliary pancreatitis (ABP). MethodsThe medical records of patients presenting with ABP from January 2008 to July 2013 were reviewed to assess the value of MRCP in detecting CBD stones in ABP. Endoscopic retrograde cholangiopancreatography (ERCP) was used as the reference standard to assess the diagnostic yield of MRCP in detecting choledocholithiasis. When ERCP was unavailable, intraoperative cholangiography or clinical follow-up was used as the reference standard. ResultsSeventy-eight patients who underwent MRCP were diagnosed with ABP, and thirty of the 78 patients (38%) were confirmed to have CBD stones per the study protocol. The sensitivity of MRCP in detecting CBD stones in ABP was 93.3% compared to 66.7% for abdominal CT (P < 0.008). The overall accuracy of MRCP in detecting choledocholithiasis was 85.9% compared to 74.0% for abdominal CT (P < 0.041). The area under the receiver operating characteristic curve (AUC) of MRCP in detecting CBD stones was 0.882, which was more accurate than the AUC of 0.727 for abdominal CT (P = 0.039). In 38 patients who underwent ERCP, the sensitivity and negative predictive value of MRCP in detecting CBD stones were both 100% regardless of the dilatation of the bile duct (≥7 mm versus < 7 mm). ConclusionMRCP is an effective, noninvasive modality to detect CBD stones in ABP and can help identify patients who require ERCP.

The value of magnetic resonance cholangiopancreatography for the exclusion of choledocholithiasis

Objective: To investigate the ability of Magnetic resonance cholangiopancreatography (MRCP) to exclude choledocholithiasis (CDL) in symptomatic patients.Material and methods: Patients suspected of choledocholithiasis who underwent MRCP from 2008 through 2013 in a population based study at the National University Hospital of Iceland were retrospectively analysed, using ERCP and/or intraoperative cholangiography as a gold standard diagnosis for CDL.Results: Overall 920 patients [66% women, mean age 55 years (SD 21)] underwent MRCP. A total of 392 patients had a normal MRCP of which 71 underwent an ERCP investigation demonstrating a CBD stone in 29 patients. A normal MRCP was found to have a 93% negative predictive value (NPV) and 89% probability of having no CBD stone demonstrated as well as no readmission due to gallstone disease within six months following MRCP. During a 6-month follow-up period of the 321 patients who did not undergo an ERCP nine (2.8%) patients were readmitted with right upper quadrant pain and elevated liver tests which later normalised with no CBD stone being demonstrated, three (0.9%) patients were readmitted with presumed gallstone pancreatitis, two (0.6%) patients were readmitted with cholecystitis and two (0.6%) patients were lost to follow-up. Seven patients of those 321 underwent an intraoperative cholangiography (IOC) and all were negative for CBD stones. For the sub-group requiring ERCP following a normal MRCP the NPV was 63%.Conclusion: Our results support the use of MRCP as a tool for exclusion of choledocholithiasis with the potential to reduce the amount of unnecessary ERCP procedures.

Diagnostic value of magnetic resonance cholangiopancreatography in choledocholithiasis.

To evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) in patients with choledocholithiasis. We systematically searched MEDLINE, EMBASE, Web of Science, and Cochrane databases for studies reporting on the sensitivity, specificity and other accuracy measures of diagnostic effectiveness of MRCP for detection of common bile duct (CBD) stones. Pooled analysis was performed using random effects models, and receiver operating characteristic curves were generated to summarize overall test performance. Two reviewers independently assessed the methodological quality of studies using standards for reporting diagnostic accuracy and quality assessment for studies of diagnostic accuracy tools. A total of 25 studies involving 2310 patients with suspected choledocholithiasis and 738 patients with CBD stones met the inclusion criteria. The average inter-rater agreement on the methodological quality checklists was 0.96. Pooled analysis of the ability of MRCP to detect CBD stones showed the following effect estimates: sensitivity, 0.90 (95%CI: 0.88-0.92, χ (2) = 65.80; P < 0.001); specificity, 0.95 (95%CI: 0.93-1.0, χ (2) = 110.51; P < 0.001); positive likelihood ratio, 13.28 (95%CI: 8.85-19.94, χ (2) = 78.95; P < 0.001); negative likelihood ratio, 0.13 (95%CI: 0.09-0.18, χ (2) = 6.27; P < 0.001); and diagnostic odds ratio, 143.82 (95%CI: 82.42-250.95, χ (2) = 44.19; P < 0.001). The area under the receiver operating characteristic curve was 0.97. Significant publication bias was not detected (P = 0.266). MRCP has high diagnostic accuracy for the detection of choledocholithiasis. MRCP should be the method of choice for suspected cases of CBD stones.

Diagnostic value of magnetic resonance cholangiopancreatography to detect bile duct stones in acute biliary pancreatitis

This paper discusses the performance of the temperature perturbation-type ADMS-Temperature and Humidity Model (ADMS-TH) and the Computational Fluid Dynamics (CFD)-based model ENVI-met for the prediction of urban air temperature using measurements collected in the city of Lecce (IT) in summer 2012. The goal is to identify the most important factors influencing numerical predictions. Direct comparisons with measured data and statistical indices show that modelled results are within the range of acceptance. Daily trends are well captured although an underestimation of maximum temperature is observed. In ADMS-TH this is due to an underestimation of sensible heat fluxes during daytime, while in ENVI-met it can be attributed to an underestimation of turbulent momentum and thermal diffusivity. Overall, ADMS-TH did predict the temperature cycle with higher accuracy than ENVI-met and its performance was particularly good during the night. ENVI-met required an ad-hoc tuning of surface boundary conditions to predict nocturnal cooling, satisfactorily.

Diagnostics of biliary dilatation by means of magnetic resonance cholangiopancreatography.

SummaryBackgroundMagnetic resonance cholangiopancreatography is a relatively noninvasive technique of biliary and pancreatic duct imaging. MRCP technique utilizes T2-weighted sequences, in which bile is characterized by high signal intensity, whilst signal intensity of surrounding tissues is reduced.The purpose of this publication was to assess the diagnostic value of magnetic resonance cholangiopancreatography in the diagnostics of biliary dilatation.Material/MethodsMRCP examinations of 148 patients (48 men and 100 women; the average age was 56) performed on a 1.5T Achieva Philips device in the Provincial Hospital in Rzeszow between November 2011 and April 2013 were included in retrospective analysis. Examined group was divided into three subgroups: patients after cholecystectomy, patients with cholecystolithiasis and patients without gallbladder concretions. The definitive cause of biliary dilatation was determined mainly on the basis of MRCP and ECPW examinations, and, in individual cases, during intraoperative cholangiography and laparatomy.ResultsSignal loss corresponding to probable concretions was identified in 34 cases. In the group of patients with cholecystolithiasis the cause of biliary dilatation was usually (45%) cholelithiasis. MRCP image was typical in 4 out of 9 malignant cases. The cause of biliary dilatation was usually (20%) a neoplasm in the group of patients without gallstones. Benign causes of biliary dilatation, apart from cholelithiasis, were identified in 16 individuals, including 4 cases in which the diagnosis was identified using MRCP, whereas in the remaining 12 cases ECPW examination proved conclusive to the final diagnosis.ConclusionsMagnetic resonance cholangiopancreatography enables reliable diagnosis of causes of biliary dilatation as long as they involve presence of gallbladder deposits and tumors. In benign causes of biliary dilatation, apart from cholelithiasis, MRCP picture is often atypical and therefore, the final identification of the cause of biliary dilatation is possible when this imagining method is combined with ERCP and additional tests.

Diagnostic Value of Magnetic Resonance Cholangiopancreatography for Biliary Complications in Orthotopic Liver Transplantation: A Meta-analysis

Background and ObjectiveMagnetic resonance cholangiopancreatography (MRCP) is a noninvasive procedure to diagnose biliary complications. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of MRCP to diagnose biliary complications post–orthotopic liver transplantation (OLT). MethodsA systematic review was performed by searching electronic bibliographic databases prior to May 2012. Sensitivity, specificity, and other measures of the accuracy of MRCP for diagnosis of post-OLT were summarized using a random-effects or a fixed-effects model. Receiver operating characteristic curves were used to summarize overall test performance. ResultsFourteen studies, which involved 892 subjects were eligible for the analysis. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under cure of MRCP for diagnosis of biliary complications were as follows: 0.95, 0.92, 10.23, 0.08, 206.59, and 0.979, respectively. The results for biliary strictures in four studies involving 177 subjects were 0.94, 0.95, 0.96, 0.09, 178.33, and 0.973 respectively. ConclusionsMRCP is a sensitive and specific technique to diagnose biliary complications.

Diagnostic value of magnetic resonance cholangiopancreatography in cholestatic jaundice

The aim of the studyTo evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography in patients with cholestatic jaundice. Patients and methodsClinical, laboratory and investigational data were evaluated from 50 patients with cholestastic jaundice. MRCP findings were compared with ERCP or operative findings and appropriate clinical endpoints. ResultsThe ERCP or operative findings and appropriate clinical endpoints revealed 23 patients with intra or extra hepatic biliary dilatation and 27 patients without intra or extra hepatic biliary dilatation. As regards the 23 patients with biliary dilatation, biliary dilatation was evident in 19 patients by U/S versus 23 patients by MRCP. ERCP was successful in 20 patients (87%) and was not done in three patients (13%). In cases of obstructive jaundice the sensitivity of MRCP was 100% versus 86% in choledocholithiasis and malignant detection, respectively p value <0.05. ConclusionMRCP is highly sensitive and specific for biliary dilatation and avoids the need for invasive imaging in most patients with cholestasis. MRCP permits reservation of ERCP to patients with a high probability of therapeutic intervention.

The value of magnetic resonance cholangiopancreatography in the detection of choledocholithiasis

Background: Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive radiological investigation, performed rapidly, and does not expose the patients to ionized radiation or iodinated contrast material. The present study was conducted to evaluate the role of MRCP in detection of common bile duct (CBD) stones in patients with suspected choledocholithiasis. Materials and Methods: This prospective study included 30 patients with suspicion of choledocholithiasis based on clinical evaluation, biochemical, or radiological investigations. Ultrasonography and MRCP were performed in all patients. All patients underwent open surgery. CBD exploration was performed in all patients, either due to presence of palpable stones or due to the presence of dilated CBD (>7 mm). Demonstration of CBD stones intraoperatively was considered the gold standard for their presence, defined as stones visualized, and extracted or attempted for extraction during surgical CBD exploration. Results: Intraoperatively, 21 (70%) out of 30 patients had cholelithiasis. 26 (86.67%) out of 30 patients had dilated CBD intraoperatively. In 20 (66.67%) out of 30 patients, choledocholithiasis was detected intraoperatively. The sensitivity, specificity, positive, and negative predictive values of ultrasonography in detecting CBD stones in the present study were 65%, 60%, 76.47%, and 46.15%, respectively. The sensitivity, specificity, positive, and negative predictive values of MRCP in diagnosis of CBD stones in the present study were 95%, 90%, 95%, and 90%, respectively. Conclusions: MRCP is a noninvasive investigation without complications and has high sensitivity, specificity, positive, and negative predictive values in detecting CBD stones. MRCP should be done in all cases with suspicion of CBD stones, where facilities and expertise are available.

The Value of Magnetic Resonance Cholangio-Pancreatography (MRCP) in the Detection of Choledocholithiasis

Magnetic Resonance Cholangio-Pancreatography (MRCP) is a non-invasive radiological investigation which can be performed rapidly and which does not expose the patients to ionised radiations or iodinated contrast material. The present study was conducted to evaluate the role of MRCP in detection of Common Bile Duct (CBD) stones in patients with suspected choledocholithiasis. This prospective study included 30 patients with a suspicion of choledocholithiasis which was based on clinical evaluation, biochemical or radiological investigations. Ultrasonography and MRCP were performed in all patients. All patients underwent open surgery. CBD exploration was performed in all patients, either due to presence of palpable stones or due to the presence of dilated CBD (> 7 mm). Demonstration of CBD stones intra-operatively was considered the 'gold standard' for their presence, defined as stones visualised and extracted or attempted for extraction during surgical CBD exploration. Intra-operatively, 21 (70%) out of 30 patients had cholelithiasis. 26 (86.67%) out of 30 patients had dilated CBD stones intra-operatively. In 20 (66.67%) out of 30 patients, choledocholithiasis was detected intra-operatively. The sensitivity, specificity, positive and negative predictive value of ultrasonography in detecting CBD stones in the present study was 65%, 60%, 76.47% and 46.15% respectively. The sensitivity, specificity, positive and negative predictive value of MRCP in diagnosis of CBD stones in the present study was 95%, 90%, 95% and 90% respectively. MRCP is a non-invasive investigation without complications and it has high sensitivity, specificity and positive and negative predictive values in detection of CBD stones. MRCP should be done in all cases with a suspicion of CBD stones, where facilities and expertise are available.

Role of magnetic resonance cholangiopancreatography for choledocholithiasis: Analysis of patients with negative MRCP

Objective. To investigate the negative predictive value of magnetic resonance cholangiopancreatography (MRCP) for common bile duct (CBD) stones and the prognosis of patients suspected to have choledocholithiasis in whom the MRCP was negative for CBD stones. Methods. We enrolled the patients suspected to have choledocholithiasis in whom the MRCP was negative for the CBD stones between January 2008 and March 2011 and retrospectively analyzed the outcomes of 115 patients. Results. Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 27 patients (23%, group 1), and none had CBD stones. The negative predictive value of MRCP was 100%. During a median follow-up of 18.3 months, acute cholangitis with newly developed CBD stones occurred in two patients. Eighty-eight patients (77%, group 2) did not undergo ERCP and all recovered from acute cholangitis without CBD surgery. During a median follow-up of 18.7 months, acute cholangitis, acute cholecystitis, gallstone pancreatitis, and pancreatico-biliary cancers occurred in four (4.6%), three (3.5%), one (1.2%), and three (3.5%) patients, respectively. New CBD stones were found in only two patients among four patients with recurrent acute cholangitis. No patient had recurrent cholangitis caused by MRCP-missed CBD stones. The rates of recurrent cholangitis and cholangitis-free survival did not differ between groups 1 and 2. Conclusion. The negative predictive value of MRCP was very high. ERCP can be reserved for patients who are MRCP negative for choledocholithiasis, but close follow-up is needed because of recurrent cholangitis or pancreatico-biliary cancer.

Value of MRCP using oral Gd-DTPA as negative contrast materials in diagnosis of atypical juxtapapillary duodenal diverticulum

Objective To investigate value of magnetic resonance cholangiopancreatography (MRCP) using oral diluted gadolinium (Gd)-diethylenetriamine penta-acetic acid (DTPA) as negative contrast materials in diagnosis of juxtapapillary duodenal diverticulum with atypical imaging features. Methods Nineteen patients with juxtapapillary duodenal diverticula of which imaging findings were atypical underwent MRCP using oral diluted Gd-DTPA as negative contrast materials after conventional MRCP without any oral contrast materials. Results Twenty diverticula were revealed in the 19 patients. At conventional MRCP, the diverticula appeared as rounded lesion with high signal intensity. After oral administration of diluted Gd-DTPA, they disappeared at MRCP. These entities were diagnosed as duodenal diverticula for they communicate with duodenal lumen. Conclusion MRCP using oral Gd-DTPA as negative contrast materials can be helpful in obtaining definitive diagnosis of those juxtapapillary duodenal diverticula without typical imaging features.

Clinical value of magnetic resonance cholangiopancreatography for prevention of cholecystectomy-induced bile duct injury

Objective To investigate the value and clinical significance of magnetic resonance eholangiopancreatography (MRCP) as preoperative examination of cholecystectomy for prevention of cholecysteetomy-induced bile duct injury. Methods The clinical data of 1392 patients with gallbladder disease treated by eholeeysteetomy from May 2004 to May 2007 in our hospital were retrospectively analyzed. The postoperative bile duct injury was analyzed and summarized. These patients were aged between 29 and 81. Of the patients, 761 were female and 631 male. A total of 932cases were treated by laparoscopie choleeysteetomy(LC)and 460 by open choleeystectomy (O C). The 142 patients re-ceived emergency operation. All the patients were examined by ultrasound or CT before cholecysteeto-my. Among which, 572 eases were additionally scanned by MRCP. Mutation of bile duet was found in 148 eases by MRCP. In 820 cases which were not examined by MRCP, bile duct of 8 was injured.There were 5 eases whose bile duet injury resulted from anatomy variation, 2 from pathological reason and 1 from operator's manipulation. The common cause of cholecystectomy-indueed bile duct injury was anatomical confusion of the Calot's triangle. Results In 572 cases examined by MRCP, bile duet injury did not occur. In the other 820 eases, the incidences of bile duct injury were 0.98%. There wassignificant difference in the incidences of bile duct injury between the 2 groups (X2=4.04, P<0.05).Conclusion For prevention of cholecystectomy-indueed bile duct injury, MRCP as preoperative exami-nation of eholeeysteetomy should be deserved to spread clinically. Prevention for iatrogenie bile duet injury is very important because it is difficult to cure. The main cause of choleeysteetomy-indueed bile duct injury is wrongly identifying the anatomy of the Calot's triangle. Because MRCP can provide in-formation about mutation and doubtful mutation of bile duet before cholecystectomy and help operator to identify the anatomy of the Calot's triangle, it can degrade eholeeystectomy-indueed bile duet injury. Key words: Cholecystectomy; Magnetic resonance cholangiopanereatography; Bile duct in-jury; Value

A comparison between endoscopic retrograde and magnetic resonance cholangiopancreatography for the diagnosis of biliary obstruction diseases

Objective To evaluate the value of magnetic resonance cholangiopancreatography(MRCP) in the diagnosis of biliary obstruction diseases by comparison with endoscopic retrograde cholangiopancreatography (ER-CP). Methods A total of 36 patients with biliary obstruction diseases underwent both MRCP and ERCP. To review the images obtained from ERCP and MRCP ,the diagnosis were compared according to pathology. MRCP and ERCP in the diagnosis and treatment of biliary obstruction disease were analysed. Results 36 patients including 16 biliary tumors, 15 cholelithiases,and five other diseases were analysed. The diagnosis accuracy of MRCP and ERCP for bil-iary obstruction diseases were 86.1% and 91.7 %, there was no significant difference( P > 0.05). Conclusion MR-CP can accurately define the obstructively sites, identify the obstructive causes and is a noninvasive and reliable exam-ination for biliary obstruction diseases. Key words: Cholangiopanereatography, magnetic resonance imaging; Cholangiopancreatography, endoscopic retrograde; Biliary tract disease

Meta-Analysis of Magnetic Resonance Cholangiopancreatography (MRCP) Demonstrates High Predictive Value of MRCP for Primary Sclerosing Cholangitis (PSC)

Meta-Analysis of Magnetic Resonance Cholangiopancreatography (MRCP) Demonstrates High Predictive Value of MRCP for Primary Sclerosing Cholangitis (PSC)