Abstract
Background
The relative roles of magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) in the investigation of malignant common bile duct (CD) strictures were evaluated using “evidence-based practice” (EBP) methodology.
Methods
A focused clinical question was constructed. A structured search of primary and secondary evidence was performed. Retrieved studies were appraised for validity, strength and level of evidence (Oxford/CEBM scale: 1–5).
Results
Three studies were eligible for inclusion; there were 2 level 3b and 1 level 4 papers. One paper included a patient group appropriate to the question and contained sufficient data to allow analysis. Sensitivity and specificity of MRCP and EUS were (90%, 65%) and (80%, 80%), respectively.
Conclusion
In the diagnosis of malignant CD strictures, EUS is more specific than MRCP and may allow cytology to be obtained via a trans-duodenal approach. A multi modality imaging approach is recommended.
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Acknowledgments
The author would like to thank Dr R. Gibney for highlighting this important clinical question to the group and in assisting in formulation of the structured clinical questions used to search the literature and Dr. D. Malone for his assistance with project completion and manuscript preparation. Colm McMahon is a fifth year trainee (Fellow) in the programme of the Faculty of Radiologists, Royal College of Surgeons in Ireland and learned EBP techniques in the St. Vincent’s University Hospital EBP group.
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McMahon, C.J. The relative roles of magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound in diagnosis of malignant common bile duct strictures: a critically appraised topic. Abdom Imaging 33, 10–13 (2008). https://doi.org/10.1007/s00261-007-9305-2
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DOI: https://doi.org/10.1007/s00261-007-9305-2