RESUMEN
INTRODUCTION: Choledocholithiasis is the most common cause of biliary obstruction. Each of the testing methods used in its diagnosis has its advantages and disadvantages. OBJECTIVE OF THE STUDY: The objective of this prospective study is to compare endoscopic retrograde cholangiopancreatography with magnetic resonance cholangiopancreatography in the diagnosis of choledocholithiasis on the basis of own experience and literature data. Set of patients and methodology: The set was studied from the beginning of 2007 to the end of 2012 (i.e. six years). The study assessed prospectively 45 patients (age range 28-â72 years) with symptoms of biliary obstruction, who first underwent magnetic resonance cholangiopancreatography and subsequently endoscopic retrograde cholangiopancreatography. RESULTS: The sensitivity, specificity and diagnostic accuracy of magnetic resonance cholangiopancreatography was lower, both in our set of patients and according to the literature data, compared to the endoscopic retrograde cholangiopancreatography (92%, 91% or 93 %). CONCLUSION: Considering the frequency of complications (in some cases serious ones) following endoscopic retrograde cholangiopancreatography, the magnetic resonance cholangiopancreatography is, in spite of its lower sensitivity, the method of choice in the diagnosis of choledocholithiasis by means of noninvasive methods, on the basis of which it is possible to refer the patients subsequently for therapeutic endoscopic retrograde cholangiopancreatography.
Asunto(s)
Colangiopancreatografia Retrógrada Endoscópica , Pancreatocolangiografía por Resonancia Magnética , Coledocolitiasis/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Humanos , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
Technical development of ultrasonography connected with improvement of resolving power has enlarged possibilities in detection and differentiation of lymph nodes. In the current clinical practice ultrasonic examination is most frequently requested for assessment of lymph nodes in neck and axillary regions in connection with inflammatory or tumour diseases. Although the final diagnosis must be confirmed histopathologically, there exist some echographic criteria enabling with a great probability to appoint the malignant character of lymph nodes: round shape expressed by the shape index near to 1, sharp edges, heterogeneous echostructure and mainly loss of the hilar sign. In highly enlarged lymph nodes these criteria can be completed by colour Doppler examination revealing a peripheral type of intranodal vascularity and increased value of impedance indices in supply artery (RI > 0.8, PI > 1.8).