Comparison of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatobiliary diseases

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is still a gold standard in the diagnostics and treatment of pancreatobiliary diseases. Endoscopic retrograde cholangiopancreatography is also an invasive method with risk of complications. Recently, magnetic resonance cholangio-pancreatography (MRCP) has been introduced as a new non-invasive imaging method in detection of pathology in the biliary tract and pancreas. Data on the diagnostic efficacy of MRCP are still rare and incompatible.
Aim: To evaluate the clinical efficacy, safety and proper indications of MRCP in pancreatobiliary diseases.
Material and methods: We carried out a retrospective analysis of 48 patients in whom ERCP and MRCP were performed. The indications were clinical symptoms and imaging method results which revealed disease in the pancreas or bile ducts.
Results: The best efficacy of MRCP was for evaluation of bile duct obstruction. In the present study overall sensitivity and specificity values for detecting lesions in MRCP were in pancreatic diseases 100% and 62.5%, in choledocholithiasis 93.8% and 80%, in primary sclerosing cholangitis (PSC) 50% and 100%, respectively. Magnetic resonance cholangio-pancreatography examination was successfully performed on all patients, whereas ERCP examination was unsuccessful in 6 patients (12.5%), because of technical problems. No complications after MRCP were noted, but after ERCP they occurred in 10% of patients.
Conclusions: Magnetic resonance cholangiopancreatography is a safe and effective method in diagnostics of pancreatic diseases, mainly with restriction of the bile ducts and choledocholithiasis, but should not be recommend as a first examination in PSC.