| Avtor/Urednik | Soederman, C; von Heijne, A; Uribe, A | |
| Naslov | MRCP with and withouth CCK-injection in diagnosing sclerosing cholangitis | |
| Prevedeni naslov | Diagnostika skleroznega holangitisa z MRCP - tudi z dodanim holecistokininom | |
| Tip | članek | |
| Vir | Endoskopska revija | |
| Vol. in št. | Letnik 4, št. 9 | |
| Leto izdaje | 1999 | |
| Obseg | str. 117-24 | |
| Jezik | eng | |
| Abstrakt | MRCP (magnetic resonance cholangio pancreatography) is a non-invasive method which could replace ERCP as first investigation in diagnosing diseases of the bile-ducts. CCK (cholecystokinin) - injection may improve the visualization of the biliary tree. Our aim was to a) investigate if MRCP can be compared with ERCP in diagnosing primary sclerosing cholangitis (PSC) and b) to investigate if CCK facilitate the visualization of the bile ducts in patients with PSC examined with MRCP. Method. 11 patients with ERCP-verified PSC were investigated. The mean levels of alcaline phosphatase and bilirubin were 14.3+-5.3 and 20+-15 microkat/l, respectively. Liver biopsies showed evidence for liver cirrhosis in 3 patients. The bile-ducts were examined with MRCP prior to and following a single intravenous injection of CCK. The hepatic parenchyme was evaluated with and without intravenous contrast. Result. Only 6/11 patients with ERCP-verified PSC (54%) had abnormalities in the bile ducts when evaluated with MRCP. In 1 of the 6 patients with ERCP-verified PSC (54%) had abnormalities in the bile ducts when evaluated with MRCP. In 1 of 6 patients which were further investigated, the intrahepatic ducts were better defined after CCK-injection. Conclusion. MRCP is inferir to ERCP in diagnosing mild/moderate cases of PSC. CCK does not rise the intraductal pressure enough to improve the visualization of the biliary tree in mild cases of PSC. However, MRCP enable to simultaneously assess the hepatic parenchyme and it is therefore a good complement to ERCP, particularly when malignancy is suspected. | |
| Izvleček | MRCP (magnetno resonančna holangio-pankreatografija) je neinvazivna metoda, ki bi lahko nadomestila ERCP (endoskopska retrogradna holangiopankreatografija) kot prva diagnostična metoda pri boleznih žolčevodov. Vbrizgavanje CCK (holecistokinin) lahko izboljša prikaz žolčevodov. Naš cilj je bil: a) ugotoviti vrednost MRCP pri odkrivanju primarno sklerozirajočega holangitisa (PSH) in to metodo primerjati z ERCP in b) ugotoviti, ali vbrizgavanje CCK pri MRCP izboljša prikaz žolčevodov pri bolnikih s PSH. Analizirali smo enajst bolnikov, pri katerih je bil z ERCP ugotovljen PSH. Srednja vrednost alkalne fosfataze je bila 14,3+-5,3 in bilirubin 20+-15 mikrokat/l. Pri treh bolnikih je bila z biopsijo ugotovljena ciroza. Žolčevode smo z MRCP prikali brez in po vbrizgavanju CCK. Jetrni parenhim je bil opazovan z in brez intravenskega kontrasta. Rezultat. Samo pri šestih bolnikih od skupno enajstih, pri katerih je ERCP pokazal prisotnost PSH (54%), je MRCP pokazala patološke spremembe žolčevodov. Pri enem bolniku so se jetrni žolčevodi bolje prikazali po vbrizganju CCK. Sklep. ERCP je za diagnostiko lažjih in srednje težkih oblik PSH boljša metoda kot MRCP. Vbrizganje CCK premalo poveč pritisk v vodih, da bi to pozitivno vplivalo na prikaz žolčevodov pri lažjih oblikah PSH. Vendar z MRP lahko hkrati ugotavljamo spremembe v jetrnem parenhimu in je zato dobra dopolnitev ERCP, predvsem kjer sumimo na maligni proces. | |
| Deskriptorji | CHOLANGITIS, SCLEROSING NUCLEAR MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE CHOLECYSTOKININ SWEDEN BILIARY TRACT DISEASES PANCREATIC DUCTS |