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Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for evaluating biliary obstruction, but the procedure can cause pancreatitis that, in turn, can be fatal. Thus, a noninvasive test that could avert the need for ERCP in some patients would be useful. Researchers performed a meta-analysis of 67 studies to compare magnetic resonance CP (MRCP) with an acceptable gold standard (e.g., ERCP, surgery, intraoperative cholangiography) in 4711 patients; the goal was to estimate the sensitivity and specificity of MRCP.
The sensitivity of MRCP varied, depending on the underlying biliary problem being detected: 88% for malignancy, 92% for bile-duct stones, 97% for the presence of obstruction, and 98% for the level of obstruction. …