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Biliyer obstrüksiyonda Manyetik Rezonans kolanjiopankreotografi’nin tanıya katkısı

Contribution of magnetic resonance cholangiopancretography to the diagnosis of biliary obstruction

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Abstract (2. Language): 
Aim: The aim of our study was to evaluate the contribution of magnetic resonance cholangiopancretography to the diagnosis of pancreoticobiliary ? system pathologies in patients who had biliary obstruction clinical and/or laboratory findings. Material–Method: One hundred and ninety eight cases? were added to the study. The cases that were thought to have obstructive biliary tract pathology but incongruous with the findings of ultrasonography and/or computerized tomography were evaluated by using magnetic resonance cholangiopancreatography. Investigation was progressed with 1.5 Tesla MR appliance and (Signa HDI, General Electric, 1Milwaukee, WI, USA), HD 8 splined body array. For statistical analysis SPSS (Statistical Package for Social Sciences) for Windows 16.0 program was used. Results: One hundred and twenty eight percent of the cases were women (64,6%), 70 % of them were men. Sixty nine out of 198 patients were operated of gall bladder. Seven patients could not be assessed by magnetic resonance cholangiopancreatography. In 43 patients, gallstone was found in saccus. 3 patients who have contracted gall blader saccus lumen could not be evaluated in terms ofgallstone . In 30 facts (15.2%) choledocholithiasis were detected. In 4 facts (2%) choledocta stent was detected. In 5 patients 2.5(%) structural scantiness was present . In 5 cases (2.5%) inner lumen filling defect in favour of air was reclaimed. Conclusion: Magnetic resonance cholangiopancreatography is a diagnostic method which has a potential to substitute endoscopic retrograde cholangiopancreatography. Because it is a non–invasive method, it has a wider usage area currently. With increasing experience and the chance of investigation wider series of patients, evaluations with magnetic resonance cholangiopancreatography will be progressed and diagnostic success rate will increase.
Abstract (Original Language): 
Amaç: Çalışmamızın amacı biliyer obstrüksiyon klinik ve/veya laboratuar bulguları ile gönderilen hastaların pankreotikobilier sistem patolojilerinin tespitinde manyetik rezonans kolanjiopankreotografi’nin tanıya katkısını değerlendirmektir. Gereç Yöntem: Çalışmaya 198 olgu dahil edildi. Obstrüktif safra yolu patolojisi düşünülen ancak ultrasonografi ve/ veya bilgisayarlı tomografi bulguları uyumsuz olan olgular manyetik rezonans kolanjiopankreotografi ile değerlendirildi. İnceleme 1.5 Tesla MR cihazı ile (Signa HDI, General Electric, 1Milwaukee, WI, USA), HD 8 kanallı body array coil’i kullanılarak yapıldı. İstatiksel analizler için SPSS (Statistical Package for Social Sciences) for Windows 16.0 programı kullanıldı. Bulgular: Olguların 128’i (%64,6) kadın, 70’i (%35,4) erkekdi. 198 hastanın 69’unda safra kesesi opere edilmişdi. 7 hastada safra kesesi manyetik rezonans kolanjiopankreotografi ile değerlendirilemedi. 43 hastada kesede taş izlendi. Safra kesesi kontrakte olan 3 hastada kese lümeni taş açısından değerlendirilemedi. 30 (%15,2) olguda koledokolitiazis saptandı. 4 (%2) olguda koledokta stent izlendi. 5 (%2,5) hastada striktürel darlık mevcuttu. 5 (%2,5) olguda ise lümen içi dolum defekti hava lehine değerlendirildi. Sonuç: Manyetik rezonans kolanjiopankreotografi, tanısal endoskopik retrograd kolanjiopankreotografi’nin yerine geçme potansiyeline sahip bir inceleme yöntemidir. Non– invaziv bir yöntem olması nedeniyle günümüzde giderek daha geniş bir kullanım alanı kazanmaktadır. Deneyimin artması ve daha geniş serilerle çalışma imkanı ile manyetik rezonans kolanjiopankreotografi değerlendirmesinde ilerleme sağlanacak böylece tanısal başarı artacaktır.
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REFERENCES

References: 

1. Bilbao MK, Dotter CT, Lee TG, Katon RM.
Complications of ERCP; a study of 10000 cases.
Gastoenterology 1976;70(3):314–20
2. Fulcher AS. MRCP and ERCP in the diagnosis
of common bile duct stones. Gastrointest Endosc
2002;56(6):178–82
3. Andriulli A, Solmi L, Loperfido S, Leo P, Festa
V, Belmonte A, et al. Prophylaxis of ERCP–
related pancreatitis: a randomized, controlled
trial of somatostatin and gabexatemesylate. Clin
Gastroenterol Hepatol 2004;2:713–8
4. Sackmann M, Beuers U, Helmberger T. Biliary
imaging: magnetic resonance cholangiography
versus endoscopic retrograde cholangiography.
Journal of Hepatology 1999;30:334–8
5. Stiris MG, Tennoe B, Aadland E, Lunde OC.
MR Cholangiopancreatography and endoscopic
retrograde cholangiopancreatography in patients
with suspected common bile duct stones. Acta
Radiol 2000;41:269–72
6. Soto JA, Barish MA, Yucel EK, Siegenberg D,
Ferrucci JT, Chuttani R. Magnetic resonance
cholangiography: comparison with endoscopic
retrograde cholangiopancreatography
Gastroenterology 1996;110:589–97
7. Varghese JC, Farrell MA, Courtney G, Osborne H,
Murray FE, Lee MJ. A prospective comparison of
magnetic resonance cholangiopancreatography with
endoscopic retrograde cholangiopancreatography
in the evaluation of patients with suspected biliary
tract disease. Clin Radiol 1999;54:513–20
8. Romagnuolo J, Bardou M, Rahme E, Joseph L,
Reinhold C, Barkun AN. Magnetic resonance
cholangiopancreatography: a meta–analysis of
test performance in suspected biliary disease. Ann
Intern Med 2003;139:547–57
9. Kaltenthaler E, Vergel YB, Chilcott J, Thomas
S, Blakeborough T, Walters SJ, et al. A
systematic review and economic evaluation of
magnetic resonance cholangiopancreatography
compared with diagnostic endoscopic retrograde
cholangiopancreatography. Health Technology
Assessment 2004;8(10):1–6
10.Moon JH, Cho YD, Cha SW, Cheon YK, Ahn HC,
Kim YS, et al. The detection of bile duct stones
in suspected biliary pancreatitis: Comparison
of MRCP, ERCP, and intraductal US. Am J
Gastroenterol 2005;100:1051–7
11. Moon JH, Cho YD, Cha SW, Cheon YK, Ahn HC,
Kim YS, et al. The detection of bile duct stones
in suspected biliary pancreatitis: comparison
of MRCP, ERCP, and intraductal US. Am J
Gastroenterol 2005;100(5):1051–7
12. Kaltenthaler EC, Walters SJ, Chilcott J,
Blakeborough A, Vergel YB, Thomas S. MRCP
compared to diagnostic ERCP for diagnosis when
biliary obstruction is suspected: a systematic
review. BMC Med Imaging 2006;6:9–24
13. David V, Reinhold C, Hochman M, Chuttani
R, McKee J, Waxman I, et al. Pitfalls in the
interpretation of MR cholangiopancreatography.
AJR Am J Roentgenol 1998;170:1055–9
14. Little AF, Smith PJ, Lee WK, Hennessy OF,
Desmond PV, Banting SW, et al. Imaging of the
normal and abnormal pancreaticobiliary system
with single–shot MR cholangiopancreatography: a
pictorial review. Australas Radiol 1999;43:427–34
15. Barish MA, Yucel EK, Ferrucci JT. Magnetic
resonance cholangiopancreatography. N Engl J
Med 1999;341:258–64
16. 16– Laing AD, Gibson RN. Magnetic resonance
cholangiopancreatography. Australas Radiol
1999;43:284–93
17. Calvo MM, Bujanda L, Calderón A, Heras I,
Cabriada JL, Bernal A, et al. Role of magnetic
resonance cholangiopancreatography in patients
with suspected choledocholitiasis. Mayo Clin Proc
2002;77:422–8
18.Manfredi R, Brizi MG, Masselli G, Vecchioli
A, Marano P. Malignant biliary hilar stenosis:
MR cholangiography compared with direct
cholangiography. Radiol Med 2001;102(1–2):48–
54
19. Pavone P, Laghi A, Catalano C, Panebianco V,
Fabiano S, Passariello R. MRI of the biliary and
pancreatic ducts. Eur Radiol 1999; 9(8):1513–22
20. Lincender L, Vrcic D, Sadagic E, Vegar S,
Mornjakovic A, Stevic N. Magnetic resonance
cholangiopancreatography (MRCP): correlation
with diagnosis using ERCP. Med Arh.
2002;56(1):25–8

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