Magnetic resonance cholangiopancreatography versus endoscopic retrograde cholangiopancreatography in cholangiopancreatic disease

ABSTRACT

Endoscopic retrograde cholangiopancreatography [ERCP] has been widely used in clinical work for decades in evaluation of the pancreatobiliary tree, whereas magnetic resonance cholangiopancreatography [MRCP] has only been used in recent years. This study was conducted in gastrointestinal endoscopy center and Radiology department, Assuit university hospital from March 2003 till April 2005 using ERCP and MRCP to diagnose cholangiopancreatic lesions and compare their accuracy. 126 patients were included in the study, 78 males and 48 females referred and scheduled for ERCP. MRCP was performed 24 hours before ERCP, Either endoscopist or radiologist performed ERCP or MRCP respectively, reported separately on their findings. ERCP was performed successfully in 117 cases [92.8%], while MRCP was carried successfully in all cases. Choledocholithiasis was present in 63 cases diagnosed by ERCP, 60 cases were diagnosed by MRCP. Ampullary carcinoma was present in 14 cases diagnosed by ERCP. Only 10 cases were diagnosed by MRCP. Cholangiocarcinoma was present in 20 cases, 16 cases were diagnosed by ERCP and MRCP with equal sensitivity and specificity. Benign inflammatory strictures of the common bile duct were present in 9 cases, was illustrated in 7 cases by ERCP, only 5 cases were diagnosed by MRCP. Pancreatic cancer was present in 20 cases, 17 cases were diagnosed by ERCP, 16 cases were diagnosed by MRCP. MRCP has an equal efficacy to ERCP in diagnosis of biliary stones, Cholangiocarcinoma, pancreatic cancer, but less efficient to diagnose ampullary carcinoma