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Using kinematic MR cholangiopancreatography to evaluate biliary dilatation

 Joo Hee Kim  ;  Myeong-Jin Kim  ;  Sung IL Park  ;  Jae-Joon Chung  ;  Si Young Song  ;  Hyung Sik Yoo  ;  Jong Tae Lee 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.178(4) : 909-914, 2002 
Journal Title
Issue Date
Adult ; Aged ; Ampulla of Vater/pathology ; Cholestasis, Extrahepatic/diagnosis ; Cholestasis, Extrahepatic/etiology ; Common Bile Duct/pathology* ; Common Bile Duct Diseases/diagnosis* ; Common Bile Duct Neoplasms/diagnosis ; Dilatation, Pathologic/diagnosis ; Female ; Humans ; Magnetic Resonance Imaging*/methods ; Male ; Middle Aged ; Pancreas/pathology* ; Pancreatic Diseases/diagnosis* ; Pancreatic Neoplasms/diagnosis ; Sensitivity and Specificity
OBJECTIVE: The purpose of this study was to evaluate the usefulness of kinematic MR cholangiopancreatographic (MRCP) images as an aid in predicting the need for intervention in patients with biliary dilatation.

SUBJECTS AND METHODS: Fifty patients with suspected pancreaticobiliary disorders were separated into three groups. Group I patients had biliary dilatation with periampullary lesions (n = 16), group II patients had supraampullary obstructive lesions (n = 17), and group III patients had biliary dilatation without obstruction (n = 17). Twenty consecutive single thick-slice MRCP images were obtained in the 15 degrees or 30 degrees left anterior oblique coronal plane. Two radiologists jointly reviewed the images without knowledge of the final diagnosis. The numbers of images showing relaxation of the sphincteric segment and the configuration of the distal margin of the common bile duct for the three groups were compared.

RESULTS: Relaxation of the sphincteric segment was observed on the images of only two patients (12%) in group I but on the images of all patients in groups II and III, although not on all images. Lack of visualization of sphincteric relaxation on the kinematic MRCP images had a sensitivity of 88% and a specificity of 100% for the diagnosis of periampullary lesions. Most patients whose images did not show sphincteric relaxation required biliary intervention at the sphincter level.

CONCLUSION: Nonvisualization of sphincteric relaxation on kinematic MRCP indicates ampullary or periampullary lesions. Kinematic MRCP can be used to determine the necessity of biliary intervention in patients with biliary dilatation.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Park, Sung Il(박성일)
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Yoo, Hyung Sik(유형식)
Lee, Jong Tae(이종태)
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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