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  • Title: Usefulness of nonbreath-hold 1-shot magnetic resonance cholangiopancreatography for the evaluation of choledochal cyst in children.
    Author: Suzuki M, Shimizu T, Kudo T, Suzuki R, Ohtsuka Y, Yamashiro Y, Shimotakahara A, Yamataka A.
    Journal: J Pediatr Gastroenterol Nutr; 2006 May; 42(5):539-44. PubMed ID: 16707978.
    Abstract:
    OBJECTIVE: The aim of this study was to clarify the usefulness of magnetic resonance cholangiopancreatography (MRCP) for the evaluation of choledochal cyst in children. SUBJECTS AND METHODS: MRCP was performed preoperatively in 33 patients. The MRCP findings were compared with those of endoscopic retrograde cholangiopancreatography or intraoperative cholangiopancreatography. RESULTS: In all 33 patients, MRCP could detect choledochal cyst. The detection rate of a cyst in the main pancreatic duct was 62.2%, of abnormal union of the pancreaticobiliary junction (AUPBJ) was 53.3%, of dilatation or abnormalities of the main pancreatic duct was 75.0% and of a protein plug or stone was 76.9%. In patients under 2 years of age (group A), these findings were significantly lower than those of patients above 2 years of age (group B) [main pancreatic duct: 16.6% (1/6) vs 73.1% (19/26), P < 0.01; AUPBJ: 0.0% (0/6) vs 66.7% (16/24), P < 0.05; and protein plug or stone: 0.0% (0/2) vs 90.9% (10/11), P < 0.05]. The detection rate of AUPBJ in the patients with fusiform dilatation was superior to that of those with cystic dilatation [70% (14/20) vs 20% (2/10), P < 0.05]. In the patients with fusiform dilatation, the detection rate in group A was significantly lower than that in group B [0.0% (0/3) vs 82.4% (14/17), P < 0.01]; however, there was no significant difference between the 2 groups in the detection of cystic dilatation. CONCLUSION: In patients older than 2 years, MRCP should be the first-choice method for confirming the diagnosis and for ensuring accurate visualization of the pancreaticobiliary system.
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