The role of MR cholangiopancreatography in the evaluation of pregnant patients with acute pancreaticobiliary disease

A. Oto, R. Ernst, L. Ghulmiyyah, D. Hughes, G. Saade, G. Chaljub

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

This study aimed to determine the usefulness of MR cholangiopancreatography (MRCP) in the evaluation of pregnant patients with acute pancreaticobiliary disease and its additional value over ultrasound. MRI studies of pregnant patients who were referred because of acute pancreaticobiliary disease were included. MR images and patient charts were reviewed retrospectively to determine clinical outcome and the results of other imaging studies. 18 pregnant patients underwent MRCP because of right upper quadrant pain (n=6), pancreatitis (n=9), cholangitis (n = 1) or jaundice (n=2). 15 patients were also evaluated with ultrasound. Biliary dilatation was detected in eight patients by ultrasound, but the cause of biliary dilatation could not be determined by ultrasound in seven patients. MRCP demonstrated the aetiology in four of these patients (choledocholithiasis (n=1), Mirizzi syndrome (n=1), choledochal cyst (n = 1) and intrahepatic biliary stones (n=1)) and excluded obstructive pathology in the other four patients. MRCP was unremarkable in the seven patients who had no biliary dilatation on ultrasound. Three patients underwent only MRCP; two had choledocholithiasis and one cholelithiasis and pancreatitis. Choledocholithiasis diagnosed with MRCP (n=3) was confirmed by endoscopic retrograde cholangiopancreatography. Mirizzi syndrome (n=1) and a choledochal cyst (n = 1) were confirmed by surgery. The patients with normal MRCP (n= 12) and one patient with intrahepatic stones improved with medical treatment. MRCP appears to be a valuable and safe technique for the evaluation of pregnant patients with acute pancreaticobiliary disease. Especially when ultrasound shows biliary dilatation, MRCP can determine the aetiology and save the patient from unnecessary endoscopic retrograde cholangiopancreatography by excluding a biliary pathology.

Original languageEnglish (US)
Pages (from-to)279-285
Number of pages7
JournalBritish Journal of Radiology
Volume82
Issue number976
DOIs
StatePublished - Apr 1 2009

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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