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Multiple biliary papillomatosis: comparison of MR cholangiography with endoscopic retrograde cholangiography
Dong Jin Chung1, Sung Koo Lee, Hyun Kwon Ha
1Department of Radiology, University of Ulsan-Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea.
Purpose:
The purpose of this work was to compare MR cholangiography with endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of multiple biliary papillomatosis (MBP).
Method:
Nine patients with pathologically proven MBP underwent MR cholangiography and ERCP. A comparison was made between ERCP, multislice HASTE, and single-shot RARE. Each biliary tract was divided into five sections for assessment; therefore, 45 biliary duct areas were used for lesion detection and determination of quality of depiction.
Results:
Of the 35 segments detected by percutaneous transhepatic cholangioscopy, pathologic examinations were performed in 31 segments: papillary adenocarcinoma was proved in 28 and papillary adenoma in 3. The multislice HASTE sequence showed bile duct branches with biliary papillomatosis better than did ERCP (p = 0.0029) and single-shot RARE sequence (p = 0.0558). The multislice HASTE procedure had the highest number of lesions detected, followed by single-shot RARE and ERCP, but there was no significant difference between the imaging techniques.
Conclusion:
Our preliminary data suggest that MR cholangiography can replace ERCP for the detection of MBP.