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

@entity1 @entity2877
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard in evaluation of the biliary tree for @entity2877 . Formal indications for magnetic resonance cholangiopancreatography (MRCP) in suspected @entity2877 are lacking. Our objective was to determine if MRCP affects management of @entity1 who otherwise would undergo ERCP. A review was conducted of all MRCPs and ERCPs at our institution from 2008 to 2012 with suspected @entity2877 . @entity1 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 @entity1 for @entity2877 . Eighty-eight @entity1 were negative for @entity2877 (82%) and 76 were discharged without ERCP (71%). Thirty-one @entity1 received a diagnosis of @entity2877 and were referred for ERCP. Of the 19 @entity1 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 @entity1 underwent ERCP without a preprocedural MRCP. @entity2877 was found in 116 @entity1 (92%), whereas 12 @entity1 (9%) had no common bile duct stones and three had an alternate diagnosis. In conclusion, MRCP significantly affected the management of @entity1 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 @entity2877 @entity1 at a low cost with regard to risk and time.
