Value of Magnetic Resonance Cholangiography in Detection of Extent of Hilar Cholangiocarcinoma
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- Category: Vol. 77, June 2009
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Value of Magnetic Resonance Cholangiography in Detection of Extent of Hilar Cholangiocarcinoma, KHALED F.Z. HASSAN
Abstract
Aim of Study: To determine the extent of hilar cholangio-carcinoma, using different magnetic resonance (MR) spin-echoes.
Patients and Methods: A total of 87 patients, who presented with painless jaundice, comprised the subjects of the present study. All patients were prospectively examined with MR cholangiography after endoscopic retrograde cholangiography, percutaneous trans-hepatic cholangiography, ultrasound and CT. Only 18 patients (4 men and 14 women) had established the diagnosis of hilar cholangiocarcinoma. MR angiography was performed to provide a non-invasive angiographic picture for the hepatic artery and portal vein.
Results: MR cholangiography examinations allowed for visualization of the intrahepatic and extrahepatic bile ducts of all patients. It was able to delineate any hilar stricture, the proximal extent of the disease and the distal duct in all patients. The MR cholangiographic findings of 6 patients (33.3%) detected the tumor and its extension, similar to that of the direct cholangiograms. In the rest of patients with cholangio-graphic correlation (12 patients, 66.7%), MR cholangiography detected the mass and the exact extension in 8 patients (44.4%), while the mass was detected in 2 patients by CT and in one patient by ultrasound. As the proximal extent of tumor and stricture were clearly seen by MR cholangiographic findings, this resulted in change of the therapy plan in 8 patients (44.4%) regarding their resectability or interventional stenting.
Conclusions: MR and MR cholangiography are rapid, reliable and non-invasive diagnostic modality in the diagnosis of hilar cholangiocarcinoma.
Recommendation: Since MR cholangiography provides a wealth of relevant information, it should be used routinely for the diagnosis and staging of hilar cholangiocarcinoma.