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J Pediatr Surg ; 43(3): 579-82, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18358308

ABSTRACT

PURPOSE: Magnetic resonance cholangiopancreatography (MRCP) is not sufficient to detect pancreaticobiliary maljunction (PBM) in young infants because the main pancreatic duct is not visualized and respiratory artifacts occur. To our knowledge, there are no reports highlighting the diagnostic accuracy of evaluation using the axial planes of helical computed tomographic (CT) scanning with contrast medium instead of 3-dimensional (3D) reconstruction. The aim of this study was to describe our experience and the characteristics of 3 children with PBM diagnosed using the axial planes of helical CT with contrast medium, although they showed negative findings of PBM by MRCP, instead of 3D reconstruction. METHODS: Three patients aged from 1 month to 3 years were diagnosed with PBM using the axial planes of helical CT with contrast medium though MRCP could not show the common channel and/or the entrance of the common channel into the duodenum. RESULTS: In all 3 patients, PBM of the common channel was not revealed by MRCP. On the other hand, axial planes of contrast-enhanced helical CT scans showed PBM clearly. CONCLUSIONS: Our experience suggests that axial planes of the contrast-enhanced helical CT scan comprise an accurate tool for the diagnosis of fusiform-type PBM and could replace MRCP in younger children. Further studies are necessary for better assessment of the potential advantages and pitfalls of this modality.


Subject(s)
Cholangiopancreatography, Magnetic Resonance , Common Bile Duct/diagnostic imaging , Congenital Abnormalities/diagnosis , Pancreatic Ducts/diagnostic imaging , Tomography, Spiral Computed , Child, Preschool , Common Bile Duct/abnormalities , Common Bile Duct/surgery , Congenital Abnormalities/surgery , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Pancreatic Ducts/abnormalities , Pancreatic Ducts/surgery , Risk Assessment , Sampling Studies , Sensitivity and Specificity , Tomography, X-Ray Computed , Treatment Outcome
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