Gloria Rossi, Abstract Co-Author: Nothing to Disclose

Luigi Maruzzelli MD, Abstract Co-Author: Nothing to Disclose

Marco Sciveres, Abstract Co-Author: Nothing to Disclose

Roberto Miraglia MD, Presenter: Nothing to Disclose

Angelo Luca MD, Abstract Co-Author: Nothing to Disclose

To assess the accuracy of magnetic resonance cholangiography (MRC) and endoscopic retrograde cholangiography (ERC) in diagnosing primary sclerosing cholangitis (PSC) in children through a retrospective case-control study.

ERCs and MRCs of 7 children (median age 12, range 8-18 years) with PSC and 17 controls (median age 5, range 1-16 years) with hepatobiliary diseases other than PSC were reviewed in a blinded, random and independent way. Only patients who undergone both examinations within a 6-months period were included. One radiologist with experience in MRC and interventional radiology evaluated both ERCs and MRCs, one endoscopist independently reviewed only ERCs. Readers recorded image quality, delineation of intrahepatic bile ducts (IHD), extrahepatic bile ducts (EHD) and presence or absence of PSC. Diagnosis of PSC based on history, clinical, chemical and histological features was used as gold standard to compare ERC and MRC diagnostic accuracy.

Overall image quality was graded as very good in 57% of MRC cases and in 71% of ERC cases; difference was not statistically significant (p=0.24). Depiction of IHD was better in ERC (p≤0.023), while depiction of EHD was comparable (p=0,052). Sensitivity for the diagnosis of SC was the same (85.7%) for the radiologist in MRC and for the endoscopist in ERC. Specificity for the diagnosis of PSC was 100% for MRC and 88.2% for ERC, respectively. Diagnostic accuracy of MRC and ERC resulted very high, without statistically significant differences (p= 0,61). Agreement on the diagnosis of PSC, defined as Kendall's tau-b value, was considered good either between the two methodologies (0,65) than between the two observers (0,61) in ERC cases.

In our study ERC and MRC resulted comparable for the diagnosis of PSC in children.

These data support MRC as the first imaging approach in children with suspected PSC.

Rossi, G, Maruzzelli, L, Sciveres, M, Miraglia, R, Luca, A, Diagnosis of Primary Sclerosing Cholangitis: Magnetic Resonance Cholangiography vs Endoscopic Retrograde Cholangiography in Children.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12022995.html