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| 1 | Accuracy of magnetic resonance cholangiography compared to operative endoscopy in detecting biliary stones, a single center experience and review of literature显示文摘AIM: To compare diagnostic sensitivity, specificity and accuracy of magnetic resonance cholangiopancreatography(MRCP) without contrast medium and endoscopic ultrasound(EUS)/endoscopic retrograde cholangiopancreatography(ERCP) for biliary calculi. METHODS: From January 2012 to December 2013, two-hundred-sixty-three patients underwent MRCP at our institution, all MRCP procedure were performed with the same machinery. In two-hundred MRCP was done for pure hepatobiliary symptoms and these patients are the subjects of this study. Among these two-hundred patients, one-hundred-eleven(55.5%) underwent ERCP after MRCP. The retrospective study design consisted in the systematic revision of all images from MRCP and EUS/ERCP performed by two radiologist with a long experience in biliary imaging, an experienced endoscopist and a senior consultant in Hepatobiliopancreatic surgery. A false positive was defined an MRCP showing calculi with no findings at EUS/ERCP; a true positive was defined as a concordance between MRCP and EUS/ERCP findings; a false negative was defined as the absence of images suggesting calculi at MRCP with calculi localization/extraction at EUS/ERCP and a true negative was defined as a patient with nocalculi at MRCP ad at least 6 mo of asymptomatic followup. Biliary tree dilatation was defined as a common bile duct diameter larger than 6 mm in a patient who had an in situ gallbladder. A third blinded radiologist who examined the MRCP and ERCP data reviewed misdiagnosed cases. Once obtained overall data on sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) we divided patients in two groups composed of those having concordant MRCP and EUS/ERCP(Group A, 72 patients) and those having discordant MRCP and EUS/ERCP(Group B, 20 patients). Dataset comparisons had been made by the Student's t-test and χ2 when appropriate.RESULTS: Two-hundred patients(91 men, 109 women, mean age 67.6 years, and range 25-98 years) underwent MRCP. All patients attended regular follow-up for at least 6 mo. Morbidity and mortality related to MRCP were null. MRCP was the only exam performed in 89 patients because it did show only calculi into the gallbladder with no signs of the presence of calculi into the bile duct and symptoms resolved within a few days or after colecistectomy. The patients remained asymptomatic for at least 6 mo, and we assumed they were true negatives. One hundred eleven(53 men, 58 women, mean age 69 years, range 25-98 years) underwent ERCP following MRCP. We did not find any difference between the two groups in terms of race, age, and sex. The overall median interval between MRCP and ERCP was 9 d. In detecting biliary stones MRCP Sensitivity was 77.4%, Specificity 100% and Accuracy 80.5% with a PPV of 100% and NPV of 85%; EUS showed 95% sensitivity, 100% specificity, 95.5% accuracy with 100% PPV and 57.1% NPV. The association of EUS with ERCP performed at 100% in all the evaluated parameters. When comparing the two groups, we did not find any statistically significant difference regarding age, sex, and race. Similarly, we did not find any differences regarding the number of extracted stones: 116 stones in Group A(median 2, range 1 to 9) and 27 in Group B(median 2, range 1 to 4). When we compared the size of the extracted stones we found that the patients in Group B had significantly smaller stones: 14.16 ± 8.11 mm in Group A and 5.15 ± 2.09 mm in Group B; 95% confidence interval = 5.89-12.13, standard error = 1.577; P < 0.05. We also found that in Group B there was a significantly higher incidence of stones smaller than 5 mm: 36 in Group A and 18 in Group B, P < 0.05.CONCLUSION: Major finding of the present study is that choledocholithiasis is still under-diagnosed in MRCP. Smaller stones(< 5 mm diameter) are hardly visualized on MRCP. | Francesco A Polistina Mauro Frego Marco Bisello Emy Manzi Antonella Vardanega Bortolo Perin | 2015 | World Journal of Radiology2015，7，4： | 14 |
| 2 | Venous Lower-Limb Evaluation in Patients With Acute Pulmonary Embolism显示文摘 | Fulvio Pomero Chiara Brignone Cristina Serraino Sergio Panzone Christian Bracco Elena Migliore Paola Dalmasso Paolo Cavallo Perin Luigi Maria Fenoglio | 2011 | Southern Medical Journal2011，，6： | 2 |
| 3 | Transendocardial,autologous bone marrow cell transplantation for severe,chronic ischemic heart failure显示文摘 | DOHMANN H F BOROJEVIC R | 2003 | Circulation2003，107，18： | 1 |
| 4 | Plasma lipopolysaccharide binding protein and bactericidal/permeability-increaslng factor in GRF and HD patients显示文摘 | Perin BJG Sundaram S Snodgrass B | 1996 | J An Soc Nephrol1996，7，： | 1 |
| 5 | Cryogenic systems for cryotarget and HiPER application显示文摘 | J P Perin | | 0，，01： | 1 |
| 6 | A phase II Dose-Escalation study of allogeneic mesenchymal precursor cells in patients with ischemic or nonischemic heart failure 显示文摘 | Perin EC Borow KM Silva GV | 2015 | Circ Res2015，117，6： | 1 |
| 7 | Evaluation of the peptide nucleic acid fluorescence in situ hybridisation technology foryeast identification directly from positive blood cultures:an Italian experience显示文摘 | Farina C Perin S Andreoni S | 2012 | Mycoses2012，55，5： | 1 |
| 8 | A randomized study of transendocardial injection of autologous bone marrow mono- nuclear cells and cell function analysis in ischemic heart failure (FOCUS-HF) 显示文摘 | Perin EC Silva GV Henry TD | 2011 | Am Heart J2011，161，6： | 1 |
| 9 | Characterization of human amniotic fluid stem cells and their pluripotential capability显示文摘 | Perin L Sedrakyan S Da Sacco S | 2008 | Methods Cell Biol2008，86，： | 1 |
| 10 | Adsorption of chromium (VI) ion from aqueous solution by succinylated mercerized cellulose functionalized with quaternary ammonium groups显示文摘 | Leandro Vinícius Alves Gurgel Júlio César Perin de Melo Jorge Carvalho de Lena Laurent Frédéric Gil | 2009 | Bioresource Technology2009，，13： | 1 |
| 11 | Human amniotic fluid stem cells can integrate and differentiate into epithelial lung lineages 显示文摘 | Carraro G Perin L Sedrakyan S | 2008 | Stem Cells2008，26，11： | 1 |
| 12 | Transsendocardial,autologous bone marrow cell transplantation for severe,chronic ischemic heart failure显示文摘 | Perin EC Dohmann H Borojevoc R | 2003 | Circulation2003，107，： | 1 |
| 13 | Transendocardial, autologous bone marrow cell transplantation for severe, chronic ischemic heart failure显示文摘 | Perin EC Dohmann H Borojevoc R | 2003 | Circulation2003，107，： | 1 |
| 14 | Transendocardial,autologous bone marrow cell transplantation for severe,chronic ischemic heart failure显示文摘 | Perin EC Dohmann HF Borojevic R | 2003 | Circulation2003，107，： | 1 |
| 15 | Characterization of human amniotic fluid stem cells and their pluripotential capability显示文摘 | Perin L Sedrakyan S Da Sacco S | 2008 | Methods Cell Biol2008，86，： | 1 |
| 16 | Transendocar- dial,auto logous bone marrow cell transplantation for se- vere, chronic ischemic heart failure 显示文摘 | Perin EC Dohmann HF Borojevic R | 2003 | Circulation2003，107，18： | 1 |
| 17 | Effect of transendocardial delivery of autologous bone marrow mononuclear cells on functional capacity, left ventricular function, and perfusion in chronic heart failure: the FOCUS-CCTRN trial显示文摘 | PERIN E C WILLERSON J T PEPINE C J | 2012 | JAMA2012，307，16： | 1 |
| 18 | Altrenogest treatment associated with a farrowing induction protocol to avoid early parturition in sows显示文摘 | Gaggini T S Perin J Arend L S | 2013 | Reproduction in Domestic Animals2013，48，3： | 1 |
| 19 | Chicory in medicine显示文摘 | Perin L | 1964 | Revue de Pathologie Générale et de Physiologie Clinique1964，64，： | 1 |
| 20 | Transendocardial,autologous bone marrow cell transplantation for severe,hronic ischemic heart failure显示文摘 | Perin EC Dohmann HF Bowjedc R | 2003 | Circulation2003，107，18： | 1 |
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