Magnetic resonance cholangiopancreatography （MRCP） is being used with increasing frequency as a noninvasive alternative to diagnostic retrograde cholangiopancreatography （ERCP）. The aim of this pictorial review is...Magnetic resonance cholangiopancreatography （MRCP） is being used with increasing frequency as a noninvasive alternative to diagnostic retrograde cholangiopancreatography （ERCP）. The aim of this pictorial review is to demonstrate the usefulness of MRCP in the evaluation of pancreatic and bilian/system disorders. Because the recently developed techniques allows improved spatial resolution and permits imaging of the entire pancreaticobiliary tract during a single breath hold, MRCP is of proven utility in a variety of pancreatic and bilian/ disorders. It uses MR imaging to visualize fluid in the bilian/and pancreatic ducts as high signal intensity on T2 weighted sequences and is the newest modality for pancreatic and biliary duct imaging. Herein, we present the clinical applications of MRCP in a variety of pancreaticobiliary system disorders and conclude that it is an important diagnostic tool in terms of imaging of the pancreaticobiliary ductal system.展开更多
AIM: To investigate the technical success and clinical complication rate of a cannulated pancreatic duct with guidewire for biliary access. METHODS: During a five-year study period, a total of 2843 patients were inclu...AIM: To investigate the technical success and clinical complication rate of a cannulated pancreatic duct with guidewire for biliary access. METHODS: During a five-year study period, a total of 2843 patients were included in this retrospective analysis. Initial biliary cannulation method consisted of single-guidewire technique (SGT) for up to 5 attempts, followed by double-guidewire technique (DGT) when repeated unintentional pancreatic duct cannulation had taken place. Pre-cut papillotomy technique was reserved for when DGT had failed or no pancreatic duct cannulation had been previously achieved. Main outcome measurements were defined as biliary cannu-lation success and post-endoscopic retrograde cholangiopancreatography (ERCP) complication rate. RESULTS: SGT (92.3% success rate) was characterized by statistically significant enhanced patient outcome compared to either the DGT (43.8%, P < 0.001), pre-cut failed DGT (73%, P < 0.001) or pre-cut as first step method (80.6%, P = 0.002). Pre-cut as first step method offered a statistically significantly more favorable outcome compared to the DGT (P < 0.001). The incidence of post-ERCP pancreatitis did not differ in a statistically significant manner between either method (SGT: 5.3%, DGT: 6.1%, Pre-cut failed DGT: 7.9%, Pre-cut as first step: 7.5%) or with patients' gender. CONCLUSION: Although DGT success rate proved not to be superior to SGT or pre-cut papillotomy, it is considered highly satisfactory in terms of safety in order to avoid the risk of a pre-cut when biliary therapy is necessary in difficult-to-cannulate cases.展开更多
文摘Magnetic resonance cholangiopancreatography （MRCP） is being used with increasing frequency as a noninvasive alternative to diagnostic retrograde cholangiopancreatography （ERCP）. The aim of this pictorial review is to demonstrate the usefulness of MRCP in the evaluation of pancreatic and bilian/system disorders. Because the recently developed techniques allows improved spatial resolution and permits imaging of the entire pancreaticobiliary tract during a single breath hold, MRCP is of proven utility in a variety of pancreatic and bilian/ disorders. It uses MR imaging to visualize fluid in the bilian/and pancreatic ducts as high signal intensity on T2 weighted sequences and is the newest modality for pancreatic and biliary duct imaging. Herein, we present the clinical applications of MRCP in a variety of pancreaticobiliary system disorders and conclude that it is an important diagnostic tool in terms of imaging of the pancreaticobiliary ductal system.
文摘AIM: To investigate the technical success and clinical complication rate of a cannulated pancreatic duct with guidewire for biliary access. METHODS: During a five-year study period, a total of 2843 patients were included in this retrospective analysis. Initial biliary cannulation method consisted of single-guidewire technique (SGT) for up to 5 attempts, followed by double-guidewire technique (DGT) when repeated unintentional pancreatic duct cannulation had taken place. Pre-cut papillotomy technique was reserved for when DGT had failed or no pancreatic duct cannulation had been previously achieved. Main outcome measurements were defined as biliary cannu-lation success and post-endoscopic retrograde cholangiopancreatography (ERCP) complication rate. RESULTS: SGT (92.3% success rate) was characterized by statistically significant enhanced patient outcome compared to either the DGT (43.8%, P < 0.001), pre-cut failed DGT (73%, P < 0.001) or pre-cut as first step method (80.6%, P = 0.002). Pre-cut as first step method offered a statistically significantly more favorable outcome compared to the DGT (P < 0.001). The incidence of post-ERCP pancreatitis did not differ in a statistically significant manner between either method (SGT: 5.3%, DGT: 6.1%, Pre-cut failed DGT: 7.9%, Pre-cut as first step: 7.5%) or with patients' gender. CONCLUSION: Although DGT success rate proved not to be superior to SGT or pre-cut papillotomy, it is considered highly satisfactory in terms of safety in order to avoid the risk of a pre-cut when biliary therapy is necessary in difficult-to-cannulate cases.
