Poster Author of 1 e-Poster
SE-024 - You can mimic a result but not the creativity!! Accuracy of MRCP in radiological diagnosis of primary sclerosing cholangiopathy and its mimics in comparison to histopathology
Author of 1 Presentation
SE-024 - You can mimic a result but not the creativity!! Accuracy of MRCP in radiological diagnosis of primary sclerosing cholangiopathy and its mimics in comparison to histopathology
Abstract
Purpose
To assess the diagnostic performance of MRCP versus histopathology in evaluation of patients with suspected PSC and its mimics
Material and methods
A prospective single-centre, single blind study of 180 patients (mean age 52.44±13.77 years, range 23-72 years,136 males) with symptoms of cholestatic liver disease and suspected PSC, was undertaken at our institute over a period of 7years (Jan10- Dec16). 2D-3D MRCP,T1, T2, DWI, chemical shift & GE sequences were obtained and studied for diagnostic predictors and accuracy of parameters(irregular duct wall, central peripheral bile duct dilatation, skip areas, ballooned IHBR, gallstones, cholecystitis, pancreatitis, ascites, coexisting cirrhosis, cholangiocarcionoma, cystic duct involvement). These parameters were correlated with liver biopsy and used to predict presence of bridging-periportal fibrosis, other pathologies and secondary sclerosing cholangitis (SSC). The diagnostic performance of MRCP and its predictors was calculated using chi-square test and univariate logistic regression.
Results
MRCP showed 89.2% sensitivity 48.7%specificity, PPV 69.5%, NPV of 77.6% in comparison to liver biopsy for analysis of PSC. MRI could correctly classify 71.6%patients. 11 patients were false negative on MRCP (3 had cholangiocarcinoma, 3- SSC, Overlap syndrome-4, AIH-1, chronic biliary pathology-2).Central IHBRD,skip lesions were reported only in 5. N=40 patients were false positive on MRCP. Chronic biliary pathology (27.5%) bridging fibrosis (12.5%), periportal fibrosis (17.5%) were the commonest mimics of PSC.
Conclusion
MRCP has a good performance in diagnosis of PSC in comparison to liver biopsy, however it remains difficult to distinguish PSC from its Radiology mimics; Secondary Sclerosing Cholangitis, Auto-immune Hepatitis & bridging fibrosis where we recommend liver biopsy as an adjunct to MRCP
Presenter of 1 Presentation
SE-024 - You can mimic a result but not the creativity!! Accuracy of MRCP in radiological diagnosis of primary sclerosing cholangiopathy and its mimics in comparison to histopathology
Abstract
Purpose
To assess the diagnostic performance of MRCP versus histopathology in evaluation of patients with suspected PSC and its mimics
Material and methods
A prospective single-centre, single blind study of 180 patients (mean age 52.44±13.77 years, range 23-72 years,136 males) with symptoms of cholestatic liver disease and suspected PSC, was undertaken at our institute over a period of 7years (Jan10- Dec16). 2D-3D MRCP,T1, T2, DWI, chemical shift & GE sequences were obtained and studied for diagnostic predictors and accuracy of parameters(irregular duct wall, central peripheral bile duct dilatation, skip areas, ballooned IHBR, gallstones, cholecystitis, pancreatitis, ascites, coexisting cirrhosis, cholangiocarcionoma, cystic duct involvement). These parameters were correlated with liver biopsy and used to predict presence of bridging-periportal fibrosis, other pathologies and secondary sclerosing cholangitis (SSC). The diagnostic performance of MRCP and its predictors was calculated using chi-square test and univariate logistic regression.
Results
MRCP showed 89.2% sensitivity 48.7%specificity, PPV 69.5%, NPV of 77.6% in comparison to liver biopsy for analysis of PSC. MRI could correctly classify 71.6%patients. 11 patients were false negative on MRCP (3 had cholangiocarcinoma, 3- SSC, Overlap syndrome-4, AIH-1, chronic biliary pathology-2).Central IHBRD,skip lesions were reported only in 5. N=40 patients were false positive on MRCP. Chronic biliary pathology (27.5%) bridging fibrosis (12.5%), periportal fibrosis (17.5%) were the commonest mimics of PSC.
Conclusion
MRCP has a good performance in diagnosis of PSC in comparison to liver biopsy, however it remains difficult to distinguish PSC from its Radiology mimics; Secondary Sclerosing Cholangitis, Auto-immune Hepatitis & bridging fibrosis where we recommend liver biopsy as an adjunct to MRCP