Zeyneb Büyük Değerli, Ömer Yılmaz, Fatma Dilek Gökharman, Uğur Koşar

Pankreatikobilier Patolojilerde Manyetik Rezonans Kolanjiopankreatografi ile Endoskopik Retrograd Kolanjiopankreatografinin Karşılaştırılması

Bu çalışmanın amacı pankreatikobilier sistem patolojilerinin tespitinde manyetik rezonans kolanjiopankreatografinin (MRCP) duyarlılığı, tanıya katkısını belirlemek ve endoskopik retrograd kolanjiopankreatografi (ERCP) ile karşılaştırmaktır.ERCP günümüzde pankreatikobilier sisteminin değerlendirilmesi için halen altın standart olarak kabul edilir, ancak MRCP safra yollarının değerlendirilmesinde güvenli ve noninvaziv olması nedeniyle tanısal amaçlı ERCP'ye alternatif olabilir. MRCP'nin klinik kullanıma girmesiyle, son zamanlarda özellikle tanısal amaçlı ERCP incelemeleri sayısında azalma eğilimi görülmüştür.Klinik ve laboratuar bulguları ile obstrüktif safra yolu patolojisi düşünülen ancak ultrasonografi ve/veya bilgisayarlı tomografi bulguları kliniği açıklamada yetersiz kalan 51 hasta üzerinde yapılmıştır. Koledok taşı, koledok dilatasyonu, koledok darlıkları ve IHSY dilatasyonu tanısında MRCP'nin duyarlılık, özgüllük, pozitif prediktif değer ve negatif prediktif değeri değerlendirildi. MRCP'nin tüm safra yolları patolojilerinin değerlendirilmesinde duyarlılık, özgüllük, pozitif ve negatif prediktif değerleri sırasıyla, %85.0, %50.0, %89.4 ve %40.0 idi.MRCP deneyiminin artması ve geniş serili çalışmalarla sonuçlarda ilerleme sağlanacak ve tanısal başarı artacaktır.

Anahtar Kelimeler:

MRCP, ERCP, safra yolu patolojileri

Comparison of Magnetic Resonance Cholangiopancreatography and Endoscopic Retrograde Cholangiopancreatography in Pancreaticobiliary Pathologies

The aim of this study was to determine the sensitivity and diagnostic contribution of magnetic resonance cholangiopancreatography (MRCP) in identifying pancreaticobiliary system pathologies and compare with endoscopic retrograde cholangiopancreatography (ERCP).ERCP is currently considered the gold standard for the evaluation of the pancreaticobiliary system. However, MRCP is a safe, non-invasive diagnostic alternative to ERCP. By the introduction of MRCP into clinical use, there has recently been a tendency of decrease especially in the number of ERCP evaluations performed only for diagnostic purposes.51 patients were included in the study with clinical and laboratory findings suggestive of obstructive biliary tract pathology, but in whom the ultrasound and/or computerized tomography (CT) findings were inconclusive.Sensitivity, specificity, positive and negative predictive value of MRCP in the diagnosis of common bile duct stone, common bile duct dilatation, common bile duct strictures and intrahepatic bile duct (IHBD) dilatation were assessed. The sensitivity, specificity, and positive and negative predictive values of MRCP for the assessment of all biliary tract pathologies were 85.0%, 50.0%, 89.4%, and 40.0%, respectively.An increase in the experience of the MRCP examination and studies with larger series may provide the improvement in results; thus, an increase in diagnostic success may be established.

Keywords:

MRCP, ERCP, biliary tract pathologies,

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