American Journal of Roentgenology, Vol 170, 1491-1495, Copyright © 1998 by American Roentgen Ray Society

ARTICLES

Neoplastic pancreaticobiliary duct obstruction: evaluation with breath- hold MR cholangiopancreatography

LH Schwartz, FV Coakley, Y Sun, LH Blumgart, Y Fong and DM Panicek
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

OBJECTIVE: The purpose of this study was to investigate the use of breath-hold single-shot fast spin-echo MR cholangiopancreatography in neoplastic pancreaticobiliary duct obstruction. MATERIALS AND METHODS: Breath-hold MR cholangiopancreatography was performed for preoperative examination of 32 consecutive patients with pathologically confirmed neoplastic obstruction of the biliary tract or pancreatic duct using a single-shot fast spin-echo sequence. Two observers, unaware of clinical or pathologic findings, independently reviewed the MR cholangiopancreatograms to assess level of obstruction and site of underlying tumor. Pathologic diagnoses, based on surgical or CT-guided biopsy specimens, were pancreatic tumor (n = 12), gallbladder cancer (n = 9), intrahepatic cancer (n = 9), and ampullary cancer (n = 2). RESULTS: On the basis of conventional cholangiography, CT, and surgical findings, 20 patients had isolated bile duct obstruction, 11 patients had combined pancreatic and bile duct obstruction, and one patient had isolated pancreatic duct obstruction. Isolated bile duct obstruction was classified as lobar (n = 5), hilar (n = 12), or distal (n = 3). These levels of obstruction were correctly identified in 27 (84%) and 28 (88%) of the 32 cases by the two observers. The site of the underlying tumor was identified in 27 (84%) and 29 (91%) cases by the two observers. Good interobserver agreement was reached for both level of obstruction (kappa = .70) and identification of tumor site (kappa = .75). CONCLUSION: Breath-hold single-shot fast spin-echo MR cholangiopancreatography is accurate in identifying the level of obstruction and the site of underlying tumor in neoplastic pancreaticobiliary duct obstruction, with good interobserver agreement.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. D. Anderson, C. Wright Pinson, J. Berlin, and R. S. Chari Diagnosis and Treatment of Cholangiocarcinoma Oncologist, February 1, 2004; 9(1): 43 - 57. [Abstract] [Full Text] [PDF]

				J. Romagnuolo, M. Bardou, E. Rahme, L. Joseph, C. Reinhold, and A. N. Barkun Magnetic Resonance Cholangiopancreatography: A Meta-Analysis of Test Performance in Suspected Biliary Disease Ann Intern Med, October 7, 2003; 139(7): 547 - 557. [Abstract] [Full Text] [PDF]

				K. M. Vitellas, M. T. Keogan, C. E. Spritzer, and R. C. Nelson MR Cholangiopancreatography of Bile and Pancreatic Duct Abnormalities with Emphasis on the Single-Shot Fast Spin-Echo Technique RadioGraphics, July 1, 2000; 20(4): 939 - 957. [Abstract] [Full Text] [PDF]

				J. A. Soto, M. A. Barish, O. Alvarez, and S. Medina Detection of Choledocholithiasis with MR Cholangiography: Comparison of Three-dimensional Fast Spin-Echo and Single- and Multisection Half-Fourier Rapid Acquisition with Relaxation Enhancement Sequences Radiology, June 1, 2000; 215(3): 737 - 745. [Abstract] [Full Text]

				D. Cherqui, S. Benoist, B. Malassagne, R. Humeres, V. Rodriguez, and P.-L. Fagniez Major Liver Resection for Carcinoma in Jaundiced Patients Without Preoperative Biliary Drainage Arch Surg, March 1, 2000; 135(3): 302 - 308. [Abstract] [Full Text] [PDF]

				M. J. Gollub, D. DeCorato, and L. H. Schwartz MR Enteroclysis: Evaluation of Small-Bowel Obstruction in a Patient with Pseudomyxoma Peritonei Am. J. Roentgenol., March 1, 2000; 174(3): 688 - 690. [Full Text] [PDF]

				J. A. Soto, O. Alvarez, J. E. Lopera, F. Munera, J. C. Restrepo, and G. Correa Biliary Obstruction: Findings at MR Cholangiography and Cross-sectional MR Imaging RadioGraphics, March 1, 2000; 20(2): 353 - 366. [Abstract] [Full Text] [PDF]

				P. C. de Groen, G. J. Gores, N. F. LaRusso, L. L. Gunderson, and D. M. Nagorney Biliary Tract Cancers N. Engl. J. Med., October 28, 1999; 341(18): 1368 - 1378. [Full Text] [PDF]