A prospective pilot study: Can the biliary tree be visualized in children younger than 3 months on Magnetic Resonance Cholangiopancreatography?

Components of carotid atherosclerotic plaque can be analysed preoperatively by non-invasive advanced imaging modalities such as magnetic resonance imaging (MRI). The expression of matrix metalloproteinase-9 protein (MMP-9), which has a potential role in remodelling of atherosclerotic plaques, can be analysed immunohistochemically. The aim of the present prospective pilot study is to analyse histological characteristics and expression of MMP-9 in carotid plaques of patients undergoing carotid endarterectomy (CEA) and to investigate the correlation with preoperative clinical symptoms and MRI features. Preoperative clinical assessment, MRI imaging, postoperative histological and immunohistochemical analyses were performed. Fifteen patients with symptomatic (7/15; 47%) and asymptomatic carotid artery stenosis undergoing CEA were included. Among symptomatic patients, 5 (71%) had recent stroke and 2 (29%) had recent transient ischaemic attack with a median timing of 6 weeks (IQR:1, 18) before the surgery. Both groups did not significantly differ in respect to preoperative characteristics. Prevalence of unstable plaque was higher in symptomatic than asymptomatic patients, although it was not significant (63% vs. 37%, p=0.077). The expression of MMP-9 in CD68 cells within the plaque by semiquantitative analysis was found to be significantly higher in symptomatic as compared to asymptomatic patients (86% vs. 25% with the highest expression, p=0.014). The average microvascular density was found to be higher and lipid core area larger among both symptomatic patients and unstable carotid plaque specimens, although this did not reach statistical significance (p=0.064 and p=0.132, p=0.360 and p=0.569, respectively). Our results demonstrate that MRI is reliable in classifying carotid lesions and differentiating unstable from stable plaques. We have also shown that the expression of MMP-9 is significantly higher among symptomatic patients undergoing CEA. Trial Registration: This study has been registered at the ISRCTN registry (ID ISRCTN46536832), isrctn.org Identifier: https://www.isrctn.com/ISRCTN46536832 Keywords: atherosclerosis, carotid endarterectomy, unstable plaque, magnetic resonance imaging, matrix metalloproteinase.

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The role of magnetic resonance imaging and the expression of MMP-9 protein in the analysis of carotid atherosclerotic plaques in patients undergoing carotid endarterectomy: a prospective pilot study

Reviews in Cardiovascular Medicine ◽

10.31083/j.rcm2204167 ◽

2021 ◽

Vol 22 (4) ◽

pp. 1611

Author(s):

Davorin Sef ◽

Milan Milosevic ◽

Marin Ostric ◽

Tomislav Mestrovic ◽

Bojan Jernej ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Pilot Study ◽

Magnetic Resonance ◽

Carotid Endarterectomy ◽

Atherosclerotic Plaques ◽

Resonance Imaging ◽

Prospective Pilot Study

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Utilizing of MRCP/MRI in differentiation between benign and malignant biliary obstruction

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9i1.1173 ◽

2018 ◽

Vol 9 (1) ◽

pp. 51

Author(s):

Amjaad Majeed Hameed

Keyword(s):

Magnetic Resonance ◽

Strong Correlation ◽

Biliary Obstruction ◽

Correct Diagnosis ◽

Magnetic Resonance Cholangiopancreatography ◽

Biliary Tree ◽

Abdominal Ultrasound ◽

Final Diagnosis ◽

Pancreatic Ducts ◽

Biliary Dilatation

Obstruction is one of the most common problems in biliary tree pathology, combined magnetic resonance imaging (MRI) and Magnetic Resonance Cholangiopancreatography (MRCP) regarded as accurate imaging modalities in diagnosis the cause of obstruction and treatment planning due to information obtain from MRCP about biliary and pancreatic ducts, information obtains from MRI cross sections about surrounding parenchyma. This study was aimed to investigate the efficacy of combined MRCP and MRI in differentiation between benign and malignant causes of biliary dilatation and their sensitivity in detection specific cause of biliary dilatation. This study involved 72 patients and conducted in Al-Diwaniyah Teaching Hospital, Iraq during a period from February 2013 to June 2017, the diagnosis of biliary dilatation was done by abdominal ultrasound to all patients followed by MRCP/MRI, the results of MRCP/MRI was compared with final diagnoses done by endoscopic retrograde cholangiopancreatography (ERCP), surgical, histopathological and laboratory results. The results revealed that a strong correlation between MRCP/MRI and other gold standard tools in differentiation between benign and malignant causes of obstruction. Sensitivity, specificity, and accuracy of MRCP in differentiation between malignant and benign causes of biliary dilatation were 98.4%, 100% & 99.7% respectively. There was a strong correlation (0.990) between MRCP/MRI & final diagnosis to determine the specific cause of obstruction, correct diagnosis the cause of obstruction in 68 patients out of 72 with a sensitivity of 94%. This study concluded that combined MRCP/MRI plays an important role in differentiation benign & malignant causes of biliary obstruction and in differentiation the specific cause of obstruction. Keywords: MRI; MRCP; Biliary obstruction; ERCP

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The Role of Magnetic Resonance Cholangiopancreatography in the Diagnosis of Choledocholithiasis: Do Benefits Outweigh the Costs?

The American Surgeon ◽

10.1177/000313481508100723 ◽

2015 ◽

Vol 81 (7) ◽

pp. 720-725 ◽

Cited By ~ 9

Author(s):

William H. Ward ◽

Laura M. Fluke ◽

Benjamin D. Hoagland ◽

Gregory J. Zarow ◽

Jenny M. Held ◽

...

Keyword(s):

Bile Duct ◽

Magnetic Resonance ◽

Length Of Stay ◽

Common Bile Duct ◽

Predictive Value ◽

Demographic Data ◽

Common Bile Duct Stones ◽

Magnetic Resonance Cholangiopancreatography ◽

Biliary Tree ◽

Bile Duct Stones

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard in evaluation of the biliary tree for choledocholithiasis. Formal indications for magnetic resonance cholangiopancreatography (MRCP) in suspected choledocholithiasis are lacking. Our objective was to determine if MRCP affects management of patients who otherwise would undergo ERCP. A review was conducted of all MRCPs and ERCPs at our institution from 2008 to 2012 with suspected choledocholithiasis. Patients who underwent MRCP and ERCP were compared with those who underwent ERCP alone. Demographic data were collected and notation of whether a post-MRCP ERCP occurred was the primary variable. MRCP was performed in 107 patients for choledocholithiasis. Eighty-eight patients were negative for choledocholithiasis (82%) and 76 were discharged without ERCP (71%). Thirty-one patients received a diagnosis of choledocholithiasis and were referred for ERCP. Of the 19 patients with MRCP-diagnosed common bile duct stones, 95 per cent were confirmed by ERCP (odds ratio 18.0, P > 0.05; agreement 77%, sensitivity 0.76, specificity 0.86, positive predictive value 0.95, negative predictive value 0.50). Length of stay was similar for all groups. A total of 131 patients underwent ERCP without a preprocedural MRCP. Choledocholithiasis was found in 116 patients (92%), whereas 12 patients (9%) had no common bile duct stones and three had an alternate diagnosis. In conclusion, MRCP significantly affected the management of patients who would have undergone ERCP. MRCP did not increase length of stay and contributed to the 95 per cent positivity rate of subsequent ERCPs. These data illustrate the utility of MRCP in suspected choledocholithiasis patients at a low cost with regard to risk and time.

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