Comparative evaluation of magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography and endoscopic ultrasound in the diagnosis of portal cavernoma cholangiopathy.

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Tytuł:: Comparative evaluation of magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography and endoscopic ultrasound in the diagnosis of portal cavernoma cholangiopathy.
Autorzy:: Rai GP; Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
Nijhawan S; Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India. dr_.
Madhu MP; Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
Sharma SS; Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
Pokharna R; Department of Gastroenterology, Sawai Man Singh Medical College, Jawaharlal Nehru Marg, Gangawal Park, Jaipur, 302 004, India.
Źródło:: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology [Indian J Gastroenterol] 2015 Nov; Vol. 34 (6), pp. 442-7. Date of Electronic Publication: 2016 Jan 07.
Typ publikacji:: Comparative Study; Journal Article
Język:: English
Imprint Name(s):: Publication: India : Springer India
Original Publication: Bombay : Indian Society of Gastroenterology,
MeSH Terms:: Bile Ducts, Extrahepatic*
Cholangiopancreatography, Magnetic Resonance*
Endosonography*
Magnetic Resonance Imaging*
Portography*
Bile Duct Diseases/*diagnosis
Hypertension, Portal/*diagnosis
Portal Vein/*abnormalities
Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult
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Contributed Indexing:: Keywords: Endoscopic ultrasound; Magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography; Paracholedochal collateral; Pericholedochal collateral; Portal cavernoma cholangiopathy
SCR Disease Name:: Portal Vein, Cavernous Transformation Of
Entry Date(s):: Date Created: 20160109 Date Completed: 20161213 Latest Revision: 20191126
Update Code:: 20240104
DOI:: 10.1007/s12664-015-0610-3
PMID:: 26743101
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Background: Magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography (MRCP/MRSPV) is now the investigation of choice for the diagnosis of portal cavernoma cholangiopathy (PCC). Endoscopic ultrasound (EUS) is an emerging diagnostic modality for the diagnosis of PCC and may be better than MRCP/MRSPV to see the layer-wise localization of varices and to differentiate between varices, stone, and malignancy.
Methods: Retrospective data of 50 patients of extrahepatic portal vein obstruction (EHPVO) were collected, and comparison between MRCP/MRSPV and EUS was done for the diagnosis of PCC.
Results: Out of 50 patients, 56 % (28) were males, 44 % (22) females, and 24 % (12) symptomatic. Biliary changes were seen in 40 patients (80 %). Epicholedochal collateral (EPEC) was detected in 48 % and 20 % in MRCP/MRSPV and EUS, respectively. Perforators (PER) and intracholedochal collateral (ICC) were better seen with EUS (72 % and 48 %) as compared to MRCP/MRSPV (0 % and 8 %), and p-values were significant (<0.05). EUS has a sensitivity of 33.33 % and a specificity of 92.31 % for EPEC. Portal cavernoma (PC) and collateral at porta (CP), paracholedochal collateral (PAC), perisplenic (PS) and peripancreatic collateral (PPC), pericholedochal collateral (PEC), intrahepatic biliary radical dilatation (IHBRD), perigallbladder collateral (PG), common bile duct dilatation (CBDD) and common hepatic duct dilatation (CHDD), common bile duct stricture (CBDS), and retropancreatic collateral (RPC) were comparable between the two modalities.
Conclusions: EUS detected PER and ICC better than MRCP/MRSPV, while MRCP/MRSPV was more sensitive for detecting EPEC.

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