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Mayer, Alan N.; Connolly, Susan; Jonas, Maureen M.
Combined Program in Gastroenterology and Department of Radiology, Children's Hospital, Boston, MA.
The most commonly used diagnostic imaging tool to assess the extent of cystic liver disease is ultrasound. Magnetic resonance cholangiopancreatography (MRCP) is a new modality with potentially higher sensitivity for evaluating the character and extent of disease. To test the null hypothesis that these two modalities are equivalent in terms of liver disease assessment, we retrospectively compared ultrasound to MRCP in five patients with ARPKD (autosomal recessive polycystic kidney disease) with congenital hepatic fibrosis and one patient with ADPKD (autosomal dominant PKD).
While cystic abnormalities in the liver were noted on ultrasound in all six cases, none of the studies demonstrated bile duct disease. By contrast, in the patients with ARPKD, MRCP showed multiple areas of intrahepatic bile duct dilatation with terminal cystic structures in continuity with the biliary tree. In the one case of ADPKD, the cysts noted on MRCP were clearly not in continuity with the bile ducts, consistent with the more common association, polycystic liver disease. In all cases, the number of cysts detected was far greater using MRCP than ultrasound.
From this series, we conclude that MRCP is superior to ultrasound in the assessment of cystic liver disease. In addition to higher sensitivity, MRCP provides information on the anatomic relationship between the cysts and the biliary tree.
POSTER SESSION II
© 1999 Lippincott Williams & Wilkins, Inc.
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