DIAGNOSTIC ACCURACY OF MRCP IN EVALUATION OF PERIAMPULLARY DUODENAL DIVERTICULA – PROSPECTIVE STUDY

Abstract

Background and Objectives: Duodenal diverticula are a common finding in patients with biliary tract disorders. The objective of this study is to assess the diagnostic value of the magnetic resonance cholangiopancreatography (MRCP) in case of periampullary duodenal diverticula (PAD) using endoscopic cholangiopancreatography (ERCP) as a reference method. Methods: The study population included 350 patients with known or suspected diseases of the biliary tract, liver, and pancreas. Two radiologists interpreted the image quality and the presence of PAD in agreement . Results: In cases with a single PAD, MRCP had sensitivity 81.2%, specificity 98.6%, positive predictive value 90.9%, and negative predictive value 97%, compared to ERCP. In the case with two PAD, MRCP had sensitivity 40%, specificity 99.7%, positive predictive value 66.7% and negative predictive value 98.9%. The average volume of PAD was 3.25 cm3. In this study group patients with PAD were on average 10 years older than those without PAD (< 0.001). There was also found a significant association of PAD with choledocholithiasis (p = 0.009) and cholecystitis (p = 0.002). Interpretation and Conclusions: In conclusion, MRCP could be used as a non-invasive diagnostic modality with acceptable sensitivity and specificity in patients with suspected PAD and biliary tract diseases.

Keywords

• mrcp
• ercp
• duodenal diverticulum
• cholecystitis
• choledocholithiasis
• bile ducts