Predictors of abnormalities on magnetic resonance cholangiopancreatography: is there a role when the biliary tree is normal on previous imaging?

There is limited evidence supporting the use of magnetic resonance cholangiopancreatography (MRCP) if the biliary tree is within normal limits on ultrasound scan (US) or computed tomography (CT). The aim of this study was to assess the role of MRCP in the absence of a dilated biliary system on index...

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Published in:Annals of gastroenterology 2019-03, Vol.32 (2), p.193-198
Main Authors: Vadhwana, Bhamini, Graby, John, Lewis, Martin, Goldman, Anouchka, Sergot, Antoni, Ramsey, Catherine, Monahan, Kevin J
Format: Article
Language:English
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Summary:There is limited evidence supporting the use of magnetic resonance cholangiopancreatography (MRCP) if the biliary tree is within normal limits on ultrasound scan (US) or computed tomography (CT). The aim of this study was to assess the role of MRCP in the absence of a dilated biliary system on index imaging. A retrospective observational study of consecutive MRCP investigations (n=427) was performed between October 2010 and June 2013 at a single district general hospital. Data collected included patient demographics, clinical presentation, liver function tests (LFTs) and radiological presence of stones. Binary logistic regression and chi-square test were performed using SPSS v23. We included 358 cases, 65% female (n=231) and 35% male (n=127), with a mean age of 60 years. Of these, 63% presented with abdominal pain (n=225), with 20% having concurrent deranged LFTs (n=44) and 8% jaundice (n=18). Index imaging demonstrated a dilated biliary system >6 mm in 68% (n=245). Alkaline phosphatase (ALP) elevation was an independent positive predictor for an abnormal MRCP (P=0.003). Abnormal index imaging, ALP and clinical jaundice were all significantly associated with a positive MRCP (P
ISSN:1108-7471
1792-7463
1792-7463
DOI:10.20524/aog.2019.0352