Original articleDiagnostic Accuracy of Magnetic Resonance and Endoscopic Retrograde Cholangiography in Primary Sclerosing Cholangitis
Section snippets
Patients
From December 2001 through December 2003, there were 70 patients with liver and/or biliary diseases who underwent MRC and ERC at our tertiary care center. All patients provided informed consent at the time of entry and the study was approved by the institutional review board. As a national transplantation center and with PSC being the most frequent indication for hepatic transplantation in Norway, the gastroenterology section of the medical department in our university hospital traditionally
Depiction
Breath-hold was adequate for MIP reconstruction in 49 (74%) of 66 patients. MRC provided comparable and poorer depiction than ERC of extrahepatic and intrahepatic ducts, respectively (Table 2, Table 3). MRC was superior to ERC in depicting the gallbladder. At MRC, there was a sharp decrease in the number of examinations with excellent or good depiction from first- to second-order ducts (from 62% to 35% of examinations, Table 3), which decreased further to 8% and 3% for third- and fourth-order
Discussion
Although accepted as the gold standard of diagnosing PSC, ERC may result in false-positive and false-negative diagnoses. PSC-like cholangiographic appearance of the intrahepatic bile ducts may be seen, for example, in some cases of cirrhosis.2 False-negative diagnosis at ERC may be related to inadequate opacification of the intrahepatic ducts and subtle changes therefore may be overlooked. This was the case in 2 patients with long-duration PSC in our study because of inadequate filling of
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