scholarly journals Magnetic Resonance Cholangiopancreatography Evaluation of Biliary Tract, Gall Bladder, and Pancreas

2021 ◽  
Vol 8 (12) ◽  
pp. 710-714
Author(s):  
Rama Krishna Narra ◽  
Sivaram Prasadbabu Badisa ◽  
Tejaswini Yatam ◽  
Bhimeswarao Pasupaleti

BACKGROUND Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging method of demonstration of hepatic, cholangio- and pancreatic-systems and their duct system and depends on heavy T2-weighted (T2-W) images. The present study was undertaken to study and evaluate patients with clinical suspicion of the biliary tract, gall bladder and pancreatic pathology, with conventional magnetic resonance imaging (MRI) and MRCP and to assess the pitfalls in MRCP for the evaluation of the biliary tract, gall bladder, and pancreas. METHODS The study included sixty patients with clinical signs and symptoms of obstructive jaundice referred for MRCP to the Department of Radiodiagnosis at Katuri Medical College and Hospital and patients who were referred to the department with clinical suspicion of pancreas, gallbladder and biliary tract disease. Pregnant patients, claustrophobic patients and patients with MRI contraindications such as cardiac pacemakers, aneurysm clips and metallic implants were excluded from the study. RESULTS Most of the patients in our study were of 30 - 70 years age group. Of the sixty cases included in our study, 58 % were males and 42 % were females. In most of the patients, in our study, benign pathology was observed which included cholelithiasis and choledocholithiasis and acute pancreatitis being next common. Case of choledochal cyst were also encountered. Most of common bile duct strictures were of benign aetiology. Of the malignant pathology detected, cholangiocarcinoma followed by periampullary carcinoma and gallbladder carcinoma were commonly encountered. CONCLUSIONS Magnetic resonance pancreatic cholangiography is an imaging modality for evaluation of pancreaticobiliary disorders. MRCP detected the exact location and cause of biliary tract obstruction and aetiology was well demonstrated. Pure cholesterol stones are difficult to detect on CT because they are iso attenuating or slightly hypoattenuating to bile. Sub centimetric calculi are well demonstrated by MRCP. Malignant strictures and benign strictures are well demonstrated. MRCP being non-invasive and radiation hazard free with inherent high resolution with multiplanar imaging capability could be considered as gold standard in imaging of few gall bladder and biliary system disorders. KEYWORDS Magnetic Resonance Cholangiopancreatography, Cholelithiasis, Pancreatitis, Periampullary Carcinoma, Gall Bladder Carcinoma, Cholangiocarcinoma

2018 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Made Mahayasa ◽  
Tommy Lesmana

Latar Belakang: hepatolitiasis adalah batu empedu pada saluran empedu liver dengan insidensi 20-30% dari semua pasien yang menjalani operasi untuk penyakit batu empedu. Ada beberapa pilihan operasi hepatolitiasis, seperti hepatektomi, eksplorasi common bile duct (CBD), dan drainase saluran intrahepatik atau cholangioenterostomy (access loop procedures), dan teknik perkutaneus. Pada laporan kasus serial ini, akan dibahas aspek pemilihan operasi pada pasien dengan hepatolitiasis. Kasus: kasus pertama adalah laki-laki, 60 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan nyeri abdomen kuadran kanan atas sejak 2 minggu. Diagnosis dengan USG (ultrasonografi) abdomen dan MRCP (magnetic resonance cholangiopancreatography) menunjukkan terdapat beberapa batu di IHBD (intra hepatic bile duct), CHD (common hepatic duct), CBD, GB (gall bladder), dan sistem bilier yang melebar. Pada pasien dilakukan tindakan kolesistektomi, eksplorasi duktus, dan by pass bilio-digestive Roux en Y (access loop procedures). Kasus kedua adalah perempuan, 45 tahun, dirawat di Rumah Sakit Dr. Soetomo dengan didiagnosis batu IHBD dan CBD. Penderita telah dilakukan kolesistektomi sejak 12 tahun yang lalu. Durante operasi ditemukan atrofi lobus kiri hati. Pada pasien, dilakukan operasi dengan eksplorasi duktus, by pass bilio-digestive Roux en Y (access loop procedures), dan hepatektomi lobus kiri. Simpulan: kasus hepatolitiasis jarang terjadi di Rumah Sakit Dr. Soetomo Surabaya. Diagnosis lengkap memerlukan kombinasi modalitas pencitraan. Pembedahan tetap menjadi pilihan utama pengobatan definitif. Menurut strategi terapeutik saat ini untuk hepatolitiasis, hepatektomi tampaknya merupakan pengobatan yang paling efektif untuk pasien dengan hepatolitiasis kiri yang terisolasi jika prosedur pembedahan lain tidak dapat mengatasi semua lesi terkait. Perawatan yang baik dapat memberikan luaran yang baik.


Author(s):  
M. Vignesh Kumar

This is a prospective study done to compare the diagnostic accuracy of Magnetic Resonance Cholangiopancreatography (MRCP) in patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP) for pancreaticobiliary disorders.Majority of the study participants were males (63.3%), while the rest 36.78% of them were females and periampullary carcinoma (11.7%) and common bile duct calculus (11.7%) are the common cause of obstruction found on MRCP followed by malignant stricture (10%). The extent of obstruction was determined in most of the study participants (91.7%) by MRCP while the rest 8.3% were not determined by MRCP. The Common bile duct calculus (11.7%) is the common cause of obstruction on ERCP followed by malignant stricture (10%) and Periampullary carcinoma (10%) and 20% of the patients were found to be normal in ERCP. Among them, 71.4 % did not show MRCP and the association was found to be significant. (p- Value < 0.00).


2020 ◽  
Vol 10 (4) ◽  
pp. 392-396
Author(s):  
Rani Abu Elgasim ◽  
Ahmed Abukonna ◽  
Ala Elgyoum ◽  
Mogahid Zidan ◽  
Mustafa Mahmoud ◽  
...  

The purpose of our study was to evaluate the common bile duct (CBD) and pancreatic duct (PD) diameter among healthy adult Sudanese subjects using magnetic resonance cholangiopancreatography (MRCP). In addition, this study aimed to determine the effects of age, gender, and body height and weight on the CBD and PD diameters to establish a reference range for these ducts on MRCP, which is very useful in a daily clinical setting where MRCP is commonly performed to evaluate suspected biliary tract disease. Methods and Results: This study included 80 asymptomatic subjects who underwent MRCP. The widest diameter of the CBD and PD was measured perpendicular to their long axes using the electronic caliper. The applied MRCP imaging technique was in line with the guidelines used by Chen et al.(2012) The age, gender, medical history, body height and body weight were recorded. Among the 80 subjects, the mean CBD diameter on MRCP was 6.17±0.69 mm (range of 4-8 mm). There was a significant correlation between the CBD diameter and weight (r=0.407, P<0.001). The mean PD diameter on MRCP was 3.80±0.50mm (range of 2-5 mm). There was also a significant correlation between the PD diameter and weight (r=0.407, P<0.001). In the cohort of 80 subjects, the mean CBD diameter in females was larger than in males(6.50±0.632mm and 5.95±0.677mm, respectively), and this difference was statistically significant (P<0.05). Also, the mean PD diameter in females was statistically larger than in males (6.03±0.66mm and 5.58±0.675mm, respectively), and this difference was statistically significant (P<0.05). Our results demonstrate no significant correlation between the diameter of CBD and PD and participants' height and age. Conclusion: The importance of the current study lies in it’s being one of the few studies whose intention was to use MRCP to bridge the knowledge gap in the literature about the measurement of the CBD and PD diameter among healthy adult Sudanese subjects.


2017 ◽  
Vol 10 (3) ◽  
pp. 819-825 ◽  
Author(s):  
Eugenio Tagliaferri ◽  
Heinrich Bergmann ◽  
Sebastian Hammans ◽  
Alireza Azizi ◽  
Eckhard Stüber ◽  
...  

Isolated agenesis of the gallbladder is usually a rare asymptomatic anatomical variation, with an estimated incidence of 10–65 per 100,000. Females are more commonly affected (ratio 3: 1), with the disease typically presenting in the second or third decade of their life. Despite an absent gallbladder, half of the patients present with symptoms similar to biliary colic, which is poorly understood. The rarity of this condition combined with its clinical and radiological features often lead to a wrong preoperative diagnosis so that many patients undergo unnecessary operative intervention. Herein, we present the case of a 56-year-old female with a typical biliary colic who was diagnosed to have gallbladder agenesis. Computed tomography and magnetic resonance cholangiopancreatography allowed correct treatment and prevented an unnecessary intervention.


2019 ◽  
pp. 117-125
Author(s):  
V. T. Ivashkin ◽  
Ch. S. Pavlov ◽  
I. R. Popova ◽  
Yu. O. Shulpekova

Introduction. The term «functional disorders of the biliary tract and bile ducts» defines the conditions, which produce typical patterns of biliary pains in the absence of obvious signs of organic lesions of the gallbladder and bile ducts. The materials of the Rome IV consensus present the diagnostic criteria of their main types – functional disorders of the gall bladder and sphincter of Oddi. Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology of the University Clinical Hospital No. 2 of Sechenov University carried out a noninterventional observational program to study the experience in using Trimedat® (trimebutine maleate) in the routine outpatient and inpatient practice in the treatment of patients with functional diseases of the biliary tract. Information partners of the program are the Russian Gastroenterological Association (RGA) and the Russian Society for the Study of the Liver (RSSL).Materials and methods. The program included patients of both sexes aged 18 to 65 years with ICD-10 diagnoses «spasm of the sphincter of Oddi» (K 83.4), «postcholecystectomy syndrome» (K 91.5), «other specified diseases of the gallbladder» (K 82.8) , «other specified diseases of the bile ducts» (K 83.8), «disorders of gallbladder and biliary tract in diseases classified elsewhere» (K 87.0), if the clinical picture was consistent with functional biliary disorders according to the Rome IV criteria and in cases when the doctor decided to prescribe Trimedat® therapy. Patients were observed for 28 ± 1 days. The dynamics of biliary pain and discomfort, as well as other symptoms (in particular, nausea, flatulence) were evaluated on the background of the therapy, using the Gastrointestinal Symptom Score Scale, in which the severity of each symptom is estimated by 7 grades (Alekseev N.Yu., 2006) with adding a section to evaluate the biliary disorders. In the presence of criteria for functional disorders of the gallbladder, an ultrasound control of the fraction of its discharge was carried out before and after the therapy.Results. 100 patients (33 (33%) men and 67 (67%) women, the average age 42.2 ± 13.2 years (18–65 years)) were enrolled in the program. In accordance with the Rome IV Consensus, the majority of patients (83 (83%)) had the functional disorders of GB; in 16 (16%) patients with the removed GB, the picture corresponded to the functional disorder of SO, one patient with kept GB was diagnosed with SO dysfunction. The treatment with Trimedate® at a standard dosage resulted in a decrease in the proportion of pain in the epigastric region (in the Scale section evaluating the biliary tract symptoms), the degree of nausea and bloating. Differences between the visits were estimated by the Friedman’s test, p <0.001. In addition, other sections of the scale also showed a decrease in indicators in scores. 79 patients underwent repeated ultrasound cholecystography at the end of treatment. It showed an increase in the fraction of GB emptying.Conclusions. The use of Trimedate® in patients with functional disorders of the gall bladder and sphincter of Oddi resulted in the reduction of the severity of the main symptoms - the severity of biliary pain, nausea, bloating. The patients with GB dysfunction showed an increase in the fraction of GB emptying.


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