Diagnostic accuracy of endoscopic ultrasonography in patients with inconclusive magnetic resonance imaging diagnosis of biliopancreatic abnormalities.
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Date
2011-07
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Abstract
Aim To determine the sensitivity and specificity of endoscopic ultrasonography (EUS) in patients with inconclusive magnetic
resonance imaging/magnetic resonance cholangiopancreatography
(MRI/MRCP) in pancreatobiliary abnormalities.
Methods During 10 months, patients with pancreatobiliary
diseases referred to endoscopic retrograde cholangiopancreatography
(ERCP) because of inconclusive MRI/MRCP
diagnosis were scheduled to undergo endoscopic ultrasonography.
Patients were divided into four major groups:
patients with (i) resectable periampullary neoplasms who
were referred to a surgeon, (ii) unresectable periampullary
cancer who underwent ERCP for biliary stenting, (iii) bile
duct stone who were referred to ERCP for stone extraction,
and (iv) normal pancreatobiliary tract. Reference standards
for comparison were ERCP, surgery, a biopsy confirming
malignancy, or the clinical course during follow up (at least
12 months) in cases without evidences of malignancy.
Results One hundred and seven patients (51 men; mean
[SD] age 60.0 [15.5]) were included in the study. Final
diagnoses were common bile duct (CBD) stone (n=24),
periampullary neoplasms (n=46), others (n=23) and no
pathologic findings (n=14). EUS determined the staging for
clinical decision-making in 47 patients with neoplasms
which showed that tumors in 34 patients (79.1%) were
unresectable (advanced stage). After EUS, 47 patients
(43.9%) did not require ERCP. The accuracy of EUS for
the diagnosis of CBD stone and periampullary neoplasms
were 96.3% and 99.1%, respectively.
Conclusions EUS is a useful modality in cases of inconclusive MRI/MRCP indicating pancreatobiliary disorders.
Description
Keywords
Cholangiopancreatography, Pancreatobiliary neoplasms, Sensitivity, Specificity
Citation
Sotoudehmanesh Rasoul, Khatibian Morteza, Ghadir Mohammad-Reza, Bagheri Mohammad, Hashemi-Taheri Amir Pejman, Sedighi Nahid, Ali-Asgari Ali, Zeinali Fatemeh, Shahraeeni Shadi, Kolahdoozan Shadi. Diagnostic accuracy of endoscopic ultrasonography in patients with inconclusive magnetic resonance imaging diagnosis of biliopancreatic abnormalities. Indian Journal of Gastroenterology. 2011 Jul-Aug; 30(4): 156-160.