A comparative study of Accuracy, Sensitivity, and Specificity of MR Cholangiopancreatography versus Ultrasonography for diagnosis of hepatobiliary and pancreatic pathologies

2020 ◽  
Vol 8 (2) ◽  
pp. 47-51
Author(s):  
p Sushmita Rao
Keyword(s):  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Radiology Department ◽  
Biliary Duct ◽  
Mr Cholangiopancreatography ◽  
Medical Sciences ◽  
Metallic Implants ◽  
Signal Void ◽  
Hypochondriac Pain ◽  
Rule Out

Background: The diagnosis of abdominal pathologies is a challenge and radiology is a very important tool in diagnosis. Various methods are often used for the diagnosis of such conditions. We in the present study tried to compare the efficacy of magnetic resonance cholangiopancreatography and ultrasonography in evaluating biliary duct diseases. Methods: The present study was conducted in the Department of Radiodiagnosis, Prathima Institute of Medical Sciences, Naganur, Karimnagar. All patients presenting with recurrent pancreatitis, hypochondriac pain, jaundice presenting to the radiology department are included in the present study. Patients with metallic implants, claustrophobia are excluded from the present study. Ultrasonography was performed using a Philips HD 15 and Philips affinity 70 machine. Both curvilinear and linear probes were used in the study. Images of the biliary tree were recorded for later review. MRI-MRCP was performed on Philips ACHIEVA 1.5 Tesla MRI Scanner. Results : In this study, n=13 subjects were clinically suspected to have cholelithiasis (n=7), choledocholithiasis (n=2), and both Cholelithiasis with choledocholithiasis (n=4). Ultrasonography was able to diagnose Cholelithiasis correctly in n=5 cases, choledocholithiasis in n=1 case, Cholelithiasis with choledocholithiasis in n=4 cases and rule out Cholelithiasis in n=2 cases, but failed to identify distal CBD calculus in n=1 case (choledocholithiasis) hence having a diagnostic accuracy of 92.31% for the cholelithiasis-choledocholithiasis group. Conclusion: MR Cholangiopancreatography is very accurate in demonstrating calculi at the distal end of CBD as an area of the signal void, also in demonstrating strictures as the cause of dilatation of biliary radicals. It showed the length of the stricture segment very well and differentiated stricture as malignant and benign.

scholarly journals The triple rule out CT in acute chest pain: a challenge for emergency radiologists?

2021 ◽  
Author(s):  
Vincenzo Russo ◽  
Camilla Sportoletti ◽  
Giulia Scalas ◽  
Domenico Attinà ◽  
Francesco Buia ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Radiology ◽  
Acute Chest Pain ◽  
Radiology Workflow ◽  
Radiology Department ◽  
Atypical Chest Pain ◽  
Triple Rule Out ◽  
Good Diagnostic Accuracy ◽  
Rule Out ◽  
Ct Studies

Abstract Purpose To evaluate the feasibility of triple rule out computed tomography (TRO-CT) in an emergency radiology workflow by comparing the diagnostic performance of cardiovascular and general radiologists in the interpretation of emergency TRO-CT studies in patients with acute and atypical chest pain. Methods Between July 2017 and December 2019, 350 adult patients underwent TRO-CT studies for the assessment of atypical chest pain. Three radiologists with different fields and years of expertise (a cardioradiologist—CR, an emergency senior radiologist—SER, and an emergency junior radiologist—JER) retrospectively and independently reviewed all TRO-CT studies, by trans-axial and multiplanar reconstruction only. Concordance rates were then calculated using as reference blinded results from a different senior cardioradiologist, who previously evaluated studies using all available analysis software. Results Concordance rate was 100% for acute aortic syndrome (AAS) and pulmonary embolism (PE). About coronary stenosis (CS) for non-obstructive (<50%), CS concordance rates were 97.98%, 90.91%, and 97.18%, respectively, for CR, SER, and JER; for obstructive CS (>50%), concordance rates were respectively 88%, 85.7%, and 71.43%. Moreover, it was globally observed a better performance in the evaluation of last half of examinations compared with the first one. Conclusions Our study confirm the feasibility of the TRO-CT even in an Emergency Radiology department that cannot rely on a 24/7 availability of a dedicated skilled cardiovascular radiologist. The “undedicated” radiologists could exclude with good diagnostic accuracy the presence of obstructive stenosis, those with a clinical impact on patient management, without needing time-consuming software and/or reconstructions.

Anatomic variants of the biliary tree: diagnosis with MR cholangiopancreatography.

Radiology ◽  
1996 ◽  
Vol 199 (2) ◽  
pp. 521-527 ◽  
Author(s):  
P Taourel ◽  
P M Bret ◽  
C Reinhold ◽  
A N Barkun ◽  
M Atri
Keyword(s):  
Biliary Tree ◽  
Mr Cholangiopancreatography ◽  
Anatomic Variants

scholarly journals Visualization of biliary ducts while doing laparoscopy, using HEV LapVision

2018 ◽  
Vol 85 (4) ◽  
pp. 9-11
Author(s):  
О. V. Ogurtsov ◽  
О. V. Lukavetskyy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Cystic Duct ◽  
Simple Procedure ◽  
Biliary Tree ◽  
High Energy ◽  
Biliary Duct ◽  
Critical View ◽  
Fluorescent Cholangiography ◽  
Biliary Ducts ◽  
Intraoperative Visualization

Objective. To determine efficacy of intraoperative visualization of biliary tree, using fluorescent cholangiography (FCH) and a high–energy visible laparoscopy vison (HEV LapVison) while laparoscopic cholecystectomy performance (LCHE). Маterials and methods. In 25 patients LCHE was performed. Preoperatively fluorescein was injected intravenously for guaranteeing of the FCH performance. HEV LapVison was applied for intraoperative visualization of fluorescence. Results. Visualization of the cystic duct and its inflow into common biliary duct was guaranteed in 90% patientsх. In 13 (52%) patients the anatomic picture was typical while in 7 (28%) some variants were observed: a parallel course of cystic duct and common biliary duct, and low level of the cystic duct inflow into hepaticocholedochus. Conclusion. FCH is a simple procedure for intraoperative navigation doing and guaranteeing of «critical view on security» while performance of LCHE. FCH together with HEV LapVison constitutes a new surgical procedure, making possible revealing of extrahepatic biliary ducts. This method may be applied as additional one while doing LCHE, preventing damage of biliary ducts.

scholarly journals Anatomical variation of intrahepatic biliary duct in cadaveric liver

2019 ◽  
Vol 9 (4) ◽  
pp. 11-14
Author(s):  
Sushma Khatiwada ◽  
Budhi Nath Adhikari ◽  
Iju Shrestha
Keyword(s):  
Frequency Distribution ◽  
Single Case ◽  
Anatomical Variation ◽  
College Teaching ◽  
Biliary Tree ◽  
Anatomical Variations ◽  
Biliary Duct ◽  
Type D ◽  
Intrahepatic Bile Ducts ◽  
Hepatobiliary System

Background: Hepatobiliary system has many variations. Use of cadavers, intraoperative data and various imaging modalities are the commonly employed techniques for determining the anatomy of intrahepatic bile ducts. The vivid picture of hepatobiliary system is a must for hepatobiliary surgery and identification of frequency distribution of typical and atypical pattern and different types of atypical pattern are vital. This study aimed to uncover its frequency distribution and also to recognize the variations therein. Methods: An observational study was conducted in the Department of Anatomy, Kathmandu Medical College Teaching Hospital from July 2013 to June 2014 by taking 50 complete human cadaveric livers without evidence of injuries or previous operations. Livers were dissected, duct traced, colored, photographed and the findings were entered in a proforma. Results: Out of 50 dissected livers, 32 showed typical pattern (Type A, 64%) whereas 18 liver showed atypical pattern of confluence (36%). The type B pattern was seen in 6 (12%) and type C was seen in 8 of them (16%). Of these 8 cases, subtype C1 was observed in 6 livers (12%) and subtype C2 was found in 2 livers (4%). Type D was seen in 3 livers (6%). and all of them were of the subtype D1. There were no cases of subtype D2 and of type E. Type F was observed in a single case (2%). Conclusions: An accurate knowledge of the anatomical variations of the intrahepatic biliary tree is important for a successful hepatobiliay surgery.

scholarly journals Economic evaluation of MR cholangiopancreatography compared to diagnostic ERCP for the investigation of biliary tree obstruction

2006 ◽  
Vol 4 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Yolanda Bravo Vergel ◽  
Jim Chilcott ◽  
Eva Kaltenthaler ◽  
Stephen Walters ◽  
Anthony Blakeborough ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Biliary Tree ◽  
Mr Cholangiopancreatography

scholarly journals Bile Duct Strictures Caused by Solid Masses: MR in Differential Diagnosis and as a Prognostic Tool to Plan the Endoscopic Treatment

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Tomasz Gorycki ◽  
Michał Studniarek
Keyword(s):  
Differential Diagnosis ◽  
Bile Duct ◽  
Endoscopic Treatment ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Duct ◽  
Linear Measurements ◽  
Diagnosis And Prognosis ◽  
Signal Characteristics ◽  
Malignant Lesions ◽  
Solid Lesions

The aim of the study was to assess how realiable is differential diagnosis and prognosis for endoscopic treatment with MR signal characteristics as the qualitative parameter and magnetic resonance cholangiopancreatography (MRCP) images in cases of bile duct obstructions caused by solid masses.Material and Methods. Retrospective study of MR and MRCP images in 80 patients (mean age 58 ys) was conducted. Mean signal intensity ratio (SIR) from planar MR images and MRCP linear measurements were compared between benign and malignant lesions and in groups including the size and number of stents placed during ERCP (< 10 F <) in 51 cases in which ERCP was performed.Results. Significantly higher SIR values were encountered in malignant lesions in T2W images () and STIR T2W images (). Malignant lesions were characterised by longer strictures () and greater proximal biliary duct dilatation (). High significance for predicting ERCP conditions was found with mean SIR in STIR T2W images and stricture length.Conclusion. Probability of malignancy of solid lesions obstructing biliary duct increased with higher SIR in T2W images and with longer strictures. Passing the stricture during ERCP treatment was easier and more probable in cases of shorter strictures caused by lesions with higher SIR in STIR T2W images.

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