Diagnostic Accuracy of Magnetic Resonance Cholangiopancreatography Versus Endoscopic Retrograde Cholangiopancreatography Findings in the Postorthotopic Liver Transplant Population-Reference-Cited by-同舟云学术

Diagnostic Accuracy of Magnetic Resonance Cholangiopancreatography Versus Endoscopic Retrograde Cholangiopancreatography Findings in the Postorthotopic Liver Transplant Population

Published:2018-09-04 Issue: Volume: Page:58-64
ISSN:2054-6203
Container-title:EMJ Gastroenterology
language:
Short-container-title:EMJ Gastroenterol

Author:

Shiani Ashok¹,Lipka Seth²,Wolk Benjamin¹,Pinkas Haim²,Kumar Ambuj³,Alsi-na Angel⁴,Kemmer Nyingi⁵,Kemmer Nyingi⁵,Turner Alexandra⁴,Brady Patrick²

Affiliation:

1. Tampa General Hospital, Tampa, Florida, USA; Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA

2. Tampa General Hospital, Tampa, Florida, USA; Department of Digestive Diseases and Nutrition, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA

3. Tampa General Hospital, Tampa, Florida, USA; Department of Evidence Based Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA

4. Department of Surgery, Tampa General Medical Group, Tampa, Florida, USA

5. Department of Transplant Hepatology, Tampa General Medical Group, Tampa, Florida, USA

Abstract

Introduction: Magnetic resonance cholangiopancreatography (MRCP) is an important diagnostic tool in evaluating patients with biliary laboratory abnormalities after orthotopic liver transplant (OLT) to determine the need for more invasive procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), which can deliver therapeutic interventions. The aim of this study was to determine the diagnostic accuracy of MRCP findings using ERCP as the gold standard in a group of post-OLT patients. Methods: A retrospective review of 273 patients who underwent OLT at the University of South Florida and Tampa General Hospital, Tampa, Florida, USA, from January 2012–April 2015 was performed. A total of 52 patients who had a MRCP and underwent a subsequent ERCP were studied. Presence of anastomotic stricture, common bile duct dilation >0.7 mm, bile leak, stone, intrahepatic stricture, or extrahepatic stricture on either modality was recorded. SPSS statistical analysis software (version 22 for Windows, SPSS Inc., Chicago, Illinois, USA) was used to calculate diagnostic accuracy. Results: The mean age of the population examined was 54.5±10.5 years; 73% of the patients were male (38 of 52). Overall agreement between the two procedures ranged from 71–96%. The sensitivity, specificity, and positive and negative predictive values of MRCP for anastomotic strictures were 77%, 59%, 79%, and 56%, respectively. The sensitivity, specificity, and positive and negative predictive values of MRCP for common bile duct dilation of >0.7 mm were 64%, 95%, 82%, and 88%, respectively. Conclusion: Despite significant improvement in the technology to better visualise the biliary system on MRCP, this study found that MRCP does not appear to be sensitive or specific in this chosen population. ERCP should be considered to confirm all positive MRCP findings, and in normal MRCP cases if there are other clinical data suggesting biliary abnormalities.

Publisher

European Medical Group

Subject

Organic Chemistry,Biochemistry

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