MRCP |
Advantages |
Noninvasive |
Intravenous contrast usually given but not required |
Established technique, widely available |
Disadvantages |
Time consuming |
Contraindications such as cardiac pacemaker/defibrillator, intracranial metal clips |
False-positive studies (eg, intraductal artifacts such as air or blood, image reconstruction artifacts, motion artifacts) |
False-negative studies (eg, stones in dilated CBD or stones <5 mm in the distal duct may not be visualized well) |
EUS |
Advantages |
Very high resolution (0.1 mm) compared with MRCP (1.5 mm) |
Dynamic imaging allowing manipulation and magnification of image for better visualization |
ERCP can potentially be performed in the same setting for stone removal |
Can be performed at the bedside in critically ill patients |
Disadvantages |
More invasive than MRCP |
Need for sedation |
Risks associated with sedation (eg, cardiopulmonary compromise) and endoscopy (eg, bleeding and perforation) |
Limited availability of equipment and trained endosonographers |
Not possible or limited role in altered anatomy (eg, pyloric stenosis, Roux-en-Y bypass) |
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