6533b850fe1ef96bd12a8495
RESEARCH PRODUCT
Diagnosis of sclerosing cholangitis in children: blinded, comparative study of magnetic resonance versus endoscopic cholangiography.
Gabriele CurcioBruno GridelliMario TrainaFabio TuzzolinoSilvia RivaAngelo LucaLuigi MaruzzelliGiuseppe MaggioreGiuseppe MaggioreMarco SciveresG. Rossisubject
MaleCholangitisSclerosingCholangiographyEndoscopic RetrogradeBile Ducts ExtrahepaticROCYoung adultChildIntrahepaticCholangiopancreatography Endoscopic RetrogradeObserver Variationmedicine.diagnostic_testBile ductGastroenterologyERCMagnetic resonance cholangiographyMagnetic Resonance Imagingsclerosing cholangitiCholangiopancreatographyMRCmedicine.anatomical_structurePredictive value of testsChild PreschoolFemaleRadiologymedicine.medical_specialtyEndoscopic retrograde cholangiographyAdolescentERC; Endoscopic retrograde cholangiography; MRC; Magnetic resonance cholangiography; ROC; Receiver operating curves; SC; Sclerosing cholangitis; Adolescent; Bile Ducts Extrahepatic; Bile Ducts Intrahepatic; Case-Control Studies; Child; Child Preschool; Cholangitis Sclerosing; Female; Humans; Infant; Male; Observer Variation; Predictive Value of Tests; ROC Curve; Retrospective Studies; Sensitivity and Specificity; Young Adult; Cholangiopancreatography Endoscopic Retrograde; Magnetic Resonance Imaging; GastroenterologyCholangitis SclerosingSocio-culturaleIntrahepatic bile ductsExtrahepaticSensitivity and SpecificityYoung AdultPredictive Value of TestsmedicineHumansSCPreschoolRetrospective StudiesHepatologyReceiver operating curvesbusiness.industryInfantMagnetic resonance imagingRetrospective cohort studyGold standard (test)Bile Ducts IntrahepaticROC CurveCase-Control StudiesBile DuctsbusinessSclerosing cholangitisdescription
Summary Background Magnetic resonance cholangiography (MRC) has been validated as comparable to endoscopic retrograde cholangiography (ERC) for the diagnosis of sclerosing cholangitis (SC) in adult patients. In children, MRC is widely used based mainly on non-comparative studies. Patients and methods ERCs and MRCs of seven children (median age 9, range: 7–20 years) with SC and 17 controls (median age 6, range: 2 months–20 years) with other chronic liver diseases were reviewed in a blinded, random and independent way. All patients underwent both examinations within a 6-months slot. All ERCs and 17 MRCs were performed under general anesthesia. One radiologist evaluated both ERCs and MRCs and one interventional endoscopist independently reviewed only ERCs. Reviewers did not receive any clinical information. Diagnosis of SC, established on the basis of history, laboratory data, radiological examinations and clinical course, was used as gold standard to compare ERC and MRC diagnostic accuracy. Results Overall image quality was graded as very good in 57% of MRC and in 71% of ERC cases; difference was not statistically significant ( P = 0.24) although the probability for MRC to be diagnostic increased with patient's age. Depiction of first, second and fourth-order intrahepatic bile duct was better in ERC ( P = 0.004, 0.02 and 0.023, respectively); depiction of the extrahepatic bile duct was comparable ( P = 0.052). Diagnostic accuracy of MRC and ERC was very high, without statistically significant difference ( P = 0.61). Conclusion Despite an overall better depiction of the biliary tree by ERC, MRC is comparable for the diagnosis of SC in children. These data support MRC as the first imaging approach in children with suspected SC.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-01-01 | Clinics and research in hepatology and gastroenterology |