Multiple biliary papillomatosis: comparison of MR cholangiography with endoscopic retrograde cholangiography.

PURPOSE: The purpose of this work was to compare MR cholangiography with endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of multiple biliary papillomatosis (MBP).

METHOD: Nine patients with pathologically proven MBP underwent MR cholangiography and ERCP. A comparison was made between ERCP, multislice HASTE, and single-shot RARE. Each biliary tract was divided into five sections for assessment; therefore, 45 biliary duct areas were used for lesion detection and determination of quality of depiction.

RESULTS: Of the 35 segments detected by percutaneous transhepatic cholangioscopy, pathologic examinations were performed in 31 segments: papillary adenocarcinoma was proved in 28 and papillary adenoma in 3. The multislice HASTE sequence showed bile duct branches with biliary papillomatosis better than did ERCP (p = 0.0029) and single-shot RARE sequence (p = 0.0558). The multislice HASTE procedure had the highest number of lesions detected, followed by single-shot RARE and ERCP, but there was no significant difference between the imaging techniques.

CONCLUSION: Our preliminary data suggest that MR cholangiography can replace ERCP for the detection of MBP.