Manyetik Rezonans Kolanjiyopankreatografi Biliyer Görüntü Verilerinin Laboratuvar Verileri ile Korelasyonu
Öz
Amaç: Safra kesesi taşlarının oluşumunda, özellikle safranın kimyasal içeriği ve safra kesesinin bozulmuş hareketliliği başta olmak üzere birçok etiyoloji ön plana çıkmaktadır. Bu çalışma, merkezimizde herhangi bir nedenle MRCP çekilen hastaların radyolojik görüntüleri ve laboratuvar verilerini değerlendirerek bağlantılarını ortaya çıkarmayı amaçlamaktadır.
Gereç ve Yöntem: 2019-2020 yıllarında etik kurul onayı ile tek merkezde kolestaz ön tanısıyla MRCP yapılan hastaların verileri geriye dönük olarak incelendi. MRCP görüntülerinde koledok çapı, kolelitiyazis ve koledokolitiazis varlığı ve sistik kanal varyasyonları değerlendirildi. Ayrıca laboratuvar verileri incelenmiş ve aralarındaki ilişki istatistiksel olarak karşılaştırılmıştır.
Bulgular: Safra yolu patolojisi ön tanısıyla MRCP yapılan 193 hastanın% 59.1'i kadın (n = 114),% 40.9'u erkekti (n = 79). Ortalama yaşları 63,1 ± 19,4'tür. Hastaların% 35,3'ünde (n = 68) sistik kanal normal iken,% 64,7'sinde (n = 125) anatomik varyasyon vardı. Sistik kanalda varyasyon varlığı açısından cinsiyetler arasında fark yoktu. Varyasyon varlığı ile safra kesesi taşları arasında anlamlı bir ilişki yoktu. Ortak safra kanalı çapı ile safra kesesi taşı varlığı ve WBC, nötrofil ve ALP değerleri arasında pozitif bir korelasyon bulundu.
Sonuç: Safra kanalı varyasyonlarının safra taşı oluşumunda etkili olabileceği düşünülse de, olgu serimizde varyasyonel sistik kanalın safra taşı oluşumunda etkili olmadığı görüldü. MRCP görüntülerinde, ortak safra kanalının çapındaki artışın ve WBC, nötrofil ve ALP değerlerindeki yüksekliğin safra taşı varlığını desteklediğini gördük.
Anahtar Kelimeler
Koledok çapı Koledokolitiazis Kolelitiyazis MRCP Sistik kanal varyasyonu.
Kaynakça
- Chowdhury, A. H., & Lobo, D. N. (2011). Gallstones. Surgery (Oxford), 29(12), 610-617.
- D'Angelo, T., Racchiusa, S., Mazziotti, S., & Cicero, G. (2017). Magnetic Resonance (MR) Cholangiopancreatography Demonstration of the Cystic Duct Entering the Right Hepatic Duct. Am J Case Rep, 18, 242-245. doi:10.12659/ajcr.902620
- Guyton, A., & Hall, J. (2001). Tıbbi Fizyoloji. 10 Baskı. Nobel Kitapevi, Ankara.
- Hanbidge, A. E., Buckler, P. M., O’Malley, M. E., & Wilson, S. R. (2004). From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics, 24(4), 1117-1135.
- Hu, A. S. Y., Menon, R., Gunnarsson, R., & de Costa, A. (2017). Risk factors for conversion of laparoscopic cholecystectomy to open surgery – A systematic literature review of 30 studies. The American Journal of Surgery, 214(5), 920-930. doi:https://doi.org/10.1016/j.amjsurg.2017.07.029
- Huang, T., Cheng, Y., Chen, C., Chen, T., & Lee, T. (1996). Variants of the bile ducts: clinical application in the potential donor of living-related hepatic transplantation. Paper presented at the Transplantation proceedings.
- Kapoor, V., Peterson, M. S., Baron, R. L., Patel, S., Eghtesad, B., & Fung, J. J. (2002). Intrahepatic Biliary Anatomy of Living Adult Liver Donors: Correlation of Mangafodipir Trisodium—Enhanced MR Cholangiography and Intraoperative Cholangiography. American Journal of Roentgenology, 179(5), 1281-1286.
- Mei, Y., Chen, L., Zeng, P. F., Peng, C. J., Wang, J., Li, W. P., . . . Jia, J. H. (2019). Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. World J Clin Cases, 7(2), 137-144. doi:10.12998/wjcc.v7.i2.137
- Mortelé, K. J., & Ros, P. R. (2001). Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. American Journal of Roentgenology, 177(2), 389-394.
- Muñoz, L. E., Boeltz, S., Bilyy, R., Schauer, C., Mahajan, A., Widulin, N., . . . Herrmann, M. (2019). Neutrophil Extracellular Traps Initiate Gallstone Formation. Immunity, 51(3), 443-450.e444. doi:https://doi.org/10.1016/j.immuni.2019.07.002
- Mustafa, M. H. A. (2017). Study of Hepatobiliary Diseases using Magnetic Resonance Cholangiopancreatography (MRCP). Sudan University of Science and Technology.
- Reshetnyak, V. I. (2013). Physiological and molecular biochemical mechanisms of bile formation. World journal of gastroenterology: WJG, 19(42), 7341.
- Strazzabosco, M., & Fabris, L. (2008). Functional anatomy of normal bile ducts. The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology: Advances in Integrative Anatomy and Evolutionary Biology, 291(6), 653-660.
- Venneman, N. G., & van Erpecum, K. J. (2010). Pathogenesis of gallstones. Gastroenterol Clin North Am, 39(2), 171-183, vii. doi:10.1016/j.gtc.2010.02.010
- Wan, J., Ouyang, Y., Yu, C., Yang, X., Xia, L., & Lu, N. (2018). Comparison of EUS with MRCP in idiopathic acute pancreatitis: a systematic review and meta-analysis. Gastrointestinal Endoscopy, 87(5), 1180-1188.e1189. doi:https://doi.org/10.1016/j.gie.2017.11.028
Correlation Of Magnetıc Resonance Colangiopanchreatography Bile Duct Image Data With Laboratory Data
Öz
Purpose: Several etiologies come to the fore in gallstones' formation, especially the chemical content of bile and impaired motility of the gallbladder. This study aims to reveal the connections by evaluating the radiological images and laboratory data of patients who underwent MRCP for any reason in our center.
Material and Methods: The data of patients who underwent MRCP with a pre-diagnosis of cholestasis in a single center in 2019-2020 with the ethics committee's approval were retrospectively analyzed. Choledock diameter, presence of cholelithiasis and choledocholithiasis, and variation of the cystic duct were evaluated on MRCP images. In addition, laboratory data were examined, and the relationship between them was statistically compared.
Results: Of the 193 patients who underwent MRCP with a pre-diagnosis of bile duct pathologyi, 59.1% were female(n=114), 40.9% were male(n=79). Their mean age was 63,1±19,4. While the cystic duct was normal in 35.3%(n=68) of the patients, 64.7%(n=125) had anatomical variation. There was no difference between genders in terms of the presence of variation in the cystic canal. There was no significant relationship between the presence of variation and gallstones. A positive correlation was found between common bile duct diameter and presence of gallstones and WBC, neutrophil, and ALP values.
Conclusion: Although it is thought that bile duct variations may be effective in the formation of gallstones, it was observed that the variational cystic duct was not effective in gallstone formation in our case series. In MRCP, we found that the increase in the diameter of the common bile duct and the high values of WBC, neutrophils, and ALP support the presence of gallstones.
Anahtar Kelimeler
Choledoc diameter Choledocholithiasis Cholelithiasis MRCP Cystic duct variation
Kaynakça
- Chowdhury, A. H., & Lobo, D. N. (2011). Gallstones. Surgery (Oxford), 29(12), 610-617.
- D'Angelo, T., Racchiusa, S., Mazziotti, S., & Cicero, G. (2017). Magnetic Resonance (MR) Cholangiopancreatography Demonstration of the Cystic Duct Entering the Right Hepatic Duct. Am J Case Rep, 18, 242-245. doi:10.12659/ajcr.902620
- Guyton, A., & Hall, J. (2001). Tıbbi Fizyoloji. 10 Baskı. Nobel Kitapevi, Ankara.
- Hanbidge, A. E., Buckler, P. M., O’Malley, M. E., & Wilson, S. R. (2004). From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics, 24(4), 1117-1135.
- Hu, A. S. Y., Menon, R., Gunnarsson, R., & de Costa, A. (2017). Risk factors for conversion of laparoscopic cholecystectomy to open surgery – A systematic literature review of 30 studies. The American Journal of Surgery, 214(5), 920-930. doi:https://doi.org/10.1016/j.amjsurg.2017.07.029
- Huang, T., Cheng, Y., Chen, C., Chen, T., & Lee, T. (1996). Variants of the bile ducts: clinical application in the potential donor of living-related hepatic transplantation. Paper presented at the Transplantation proceedings.
- Kapoor, V., Peterson, M. S., Baron, R. L., Patel, S., Eghtesad, B., & Fung, J. J. (2002). Intrahepatic Biliary Anatomy of Living Adult Liver Donors: Correlation of Mangafodipir Trisodium—Enhanced MR Cholangiography and Intraoperative Cholangiography. American Journal of Roentgenology, 179(5), 1281-1286.
- Mei, Y., Chen, L., Zeng, P. F., Peng, C. J., Wang, J., Li, W. P., . . . Jia, J. H. (2019). Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. World J Clin Cases, 7(2), 137-144. doi:10.12998/wjcc.v7.i2.137
- Mortelé, K. J., & Ros, P. R. (2001). Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. American Journal of Roentgenology, 177(2), 389-394.
- Muñoz, L. E., Boeltz, S., Bilyy, R., Schauer, C., Mahajan, A., Widulin, N., . . . Herrmann, M. (2019). Neutrophil Extracellular Traps Initiate Gallstone Formation. Immunity, 51(3), 443-450.e444. doi:https://doi.org/10.1016/j.immuni.2019.07.002
- Mustafa, M. H. A. (2017). Study of Hepatobiliary Diseases using Magnetic Resonance Cholangiopancreatography (MRCP). Sudan University of Science and Technology.
- Reshetnyak, V. I. (2013). Physiological and molecular biochemical mechanisms of bile formation. World journal of gastroenterology: WJG, 19(42), 7341.
- Strazzabosco, M., & Fabris, L. (2008). Functional anatomy of normal bile ducts. The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology: Advances in Integrative Anatomy and Evolutionary Biology, 291(6), 653-660.
- Venneman, N. G., & van Erpecum, K. J. (2010). Pathogenesis of gallstones. Gastroenterol Clin North Am, 39(2), 171-183, vii. doi:10.1016/j.gtc.2010.02.010
- Wan, J., Ouyang, Y., Yu, C., Yang, X., Xia, L., & Lu, N. (2018). Comparison of EUS with MRCP in idiopathic acute pancreatitis: a systematic review and meta-analysis. Gastrointestinal Endoscopy, 87(5), 1180-1188.e1189. doi:https://doi.org/10.1016/j.gie.2017.11.028
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2021 |
| Gönderilme Tarihi | 6 Mayıs 2021 |
| Kabul Tarihi | 16 Ağustos 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 2 Sayı: 3 |
Turkish Journal of Science and Health (TFSD)
E-mail: tfsdjournal@gmail.com
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