Magnetic resonance cholangiopancreaticography with esomeprazole: comparison between single and double oral dose

The aim of this study was to compare patient's Magnetic Resonance Cholangiopancreaticography [MRCP] control images with the same patient's images after taking 40mg or 80mg Esomeprazole, and to define the medication role in improving visualization quality of images. Seventy patients attending gastroenterology clinic at Jordan University Hospital during the period first of January 2007 till the end of December 2007 were in a consecutive manner control images, then either 40 mgs or 80 mgs Esomeprazole was given and images re-obtained compared with control images for each patient. Improvement of Contrast effect on stomach and duodenum in Esomeprazole single dose group was 72.5% and in double dose group was 78.5%, while image effect of pancreatic duct was the same for single dose Esomeprazole and double dose [60%], and their statistical results were in concordance with no considerable difference, and the image effect of the biliary tree didn't show any significant difference between imaging and statistical results in both groups. Esomeprazole improves images and gives superior quality of Magnetic Resonance Cholangiopancreaticography especially the contrast effect of duodenum and stomach and image effect of pancreaticobiliary ducts. But images obtained from patients given a double dose showed no significant difference to those patients given a single dose except some advantage is seen in favor of double dose group in improving intrahepatic duct images

[De Quervain's tenosynovitis imaging: ultrasonography versus magnetic resonance imaging]

To determine the diagnostic efficiency of ultrasonography [U/S] and magnetic resonance imaging [MRI] in detecting de Quervain's tenosynovitis. Forty wrists of 29 symptomatic patients [21 females and 8 males] were selected during a 12 months period. Patients with suggestive clinical de Quervain's tenosynovitis underwent both wrist ultrasonography and magnetic resonance imaging, to determine changes in the first dorsal compartment thickness in both genders. T1-weighted images were obtained in axial, sagittal and coronal planes. Whereas, T2-weighted gradient echo images and T2-weighted fat saturation images were performed in axial and coronal planes. Cohen Kappa was used for statistical analysis. The ultrasonographic results among all diseased wrists showed 100% tendon thickening, 97.5% peritendinous edema, 72.5% decreased tendon mobility and 70% septation. The magnetic resonance imaging results showed 95% tendon thickening, 85% peritendinous edema, 62.5% increased tendon signal, 60% septation, 55% subcutaneous edema, and 45% synovial thickening among the whole group. All values demonstrated differences among genders and more prominent in females.The prime reliable finding is in respect to superiority of ultrasound in all comparable criteria which was confirmed by statistical results. Ultrasonography is considered the favorite technique to validate the clinical diagnosis. It gives special accuracy and high diagnostic capability even in early stages. Magnetic resonance imaging could be significant in doubtful clinical diagnoses not confirmed by ultrasonography. In addition, magnetic resonance imaging has advanced capability to detect other soft tissue and bone marrow abnormalities

Magnetic resonance cholangiopancreaticogram: outcomes at Jordan university hospital

Objectives: To evaluate the experience of Jordan University Hospital in magnetic resonance cholangiopancreaticogram over the period of three years and to compare the results with upper GI endoscopy, surgery, liver biopsy and endoscopic retrograde cholangiopancreaticogram

Methods: Conventional abdominal magnetic resonance examination [CAMRE] of the upper abdomen followed by Magnetic Resonance Cholangiopancreaticogram [MRCP] was performed in 174 patients. Endoscopic Retrograde Cholangioanpereaticogram [ERCP] was performed in 84 patients, upper GI endoscopy [UGIE] in 60 patients, liver biopsy in 9 patients and surgery in 40 patients

Results: Eighteen patients were excluded. In 156 patients MRCP and CAMRE were adequate. Ninety four patients [60.3%] had abnormal MRCP; 40 patients [25.6%] showed abnormality in the CAMRE. Fifty patients [55.3%] had cholidocolithiasis and 30 patients [31.9%] had malignant stricture. MRCP was normal in 62 patients [39.8 %] when ERCP_was abnormal; two patients had gallstones from this group. ERCP was successful in 77 patients out of 84 [91.7%] with endoscopic sphincterotomy and 30 patients had abnormal UGIE

Conclusion: MRCP is a very good technique in detection of pancreatic and biliary ducts pathology, its diagnostic accuracy is increased if combined with CAMRE, it should be done prior to diagnostic ERCP particularly in patients with previous un successful attempt