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Hello, Which Test Would Be Better For Ruling Out Gallbladder

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Posted on Fri, 15 Nov 2019
Question: Hello,
Which test would be better for ruling out gallbladder cancer, mri-abdomen or MCRP?
Thanks!
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Follow up: Dr. Vivek Chail (0 minute later)
Hello,
Which test would be better for ruling out gallbladder cancer, mri-abdomen or MCRP?
Thanks!
doctor
Answered by Dr. Vivek Chail (30 minutes later)
Brief Answer:
Please get MRCP done

Detailed Answer:
Hi,
Thanks for writing in.

MRCP is a modification of the MRI abdomen scan and special images are taken to see the biliary tree and pancreatic ducts on MRCP imaging.

I suggest you go for the MRCP for your condition.

Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
Please get MRCP done

Detailed Answer:
Hi,
Thanks for writing in.

MRCP is a modification of the MRI abdomen scan and special images are taken to see the biliary tree and pancreatic ducts on MRCP imaging.

I suggest you go for the MRCP for your condition.

Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
MRCP is done to see any small blocks in the biliary tree

Detailed Answer:
Hi,
Thanks for writing back.

MRCP is indicated for visualising the biliary channels and any stone blocking the common bile duct in most people with gall stones. It basically tells you if the bile is flowing normally and without any obstruction in the path of flow. My previous suggestion was based on the fact that you might be having multiple gall bladder stones.

MRCP is also a general tool used to study the flow of bile in people with or without gall bladder stones and to see any suspected area of narrowing or small blocks in the biliary tree.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
MRCP is done to see any small blocks in the biliary tree

Detailed Answer:
Hi,
Thanks for writing back.

MRCP is indicated for visualising the biliary channels and any stone blocking the common bile duct in most people with gall stones. It basically tells you if the bile is flowing normally and without any obstruction in the path of flow. My previous suggestion was based on the fact that you might be having multiple gall bladder stones.

MRCP is also a general tool used to study the flow of bile in people with or without gall bladder stones and to see any suspected area of narrowing or small blocks in the biliary tree.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vivek Chail (0 minute later)
Thanks. My surgeon said Mrcp is for liver and unnecessary for gall bladder. Any suggestions on getting him to reconsider?
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Follow up: Dr. Vivek Chail (0 minute later)
Thanks. My surgeon said Mrcp is for liver and unnecessary for gall bladder. Any suggestions on getting him to reconsider?
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Follow up: Dr. Vivek Chail (3 days later)
Thank you so much. Based on your helpful suggestion my doctor ordered an MRCP with and without contrast for tomorrow.
I do have a high risk for renal cancer and wondered if this test would detect a small renal mass and at what threshhold(mm) if it existed? Is there a way to raise awareness or create better scrutiny of my kidneys during the MRCP exam? Thanks for all you do. Your insight has been extrtemely helpful. XXXXXXX
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Follow up: Dr. Vivek Chail (0 minute later)
Thank you so much. Based on your helpful suggestion my doctor ordered an MRCP with and without contrast for tomorrow.
I do have a high risk for renal cancer and wondered if this test would detect a small renal mass and at what threshhold(mm) if it existed? Is there a way to raise awareness or create better scrutiny of my kidneys during the MRCP exam? Thanks for all you do. Your insight has been extrtemely helpful. XXXXXXX
doctor
Answered by Dr. Vivek Chail (13 hours later)
Brief Answer:
MRCP images are good to look for kidney cysts

Detailed Answer:
Hi,
Thanks for your valuable feedback.

MRCP can help in visualisation of an incidental lesion however when the size of a lesion is small, it gets difficult to confirm a cancer.

A tiny kidney cyst as small as 3 to 5 mm can be visualised during the MRCP scan. The MRCP scan sequence is best suited for looking at cyst like lesions.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
MRCP images are good to look for kidney cysts

Detailed Answer:
Hi,
Thanks for your valuable feedback.

MRCP can help in visualisation of an incidental lesion however when the size of a lesion is small, it gets difficult to confirm a cancer.

A tiny kidney cyst as small as 3 to 5 mm can be visualised during the MRCP scan. The MRCP scan sequence is best suited for looking at cyst like lesions.

Regards,
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vivek Chail (17 hours later)
Thank you! XXXXXXX showed no gallstones but my liver showed focal liver lesions:small cyst with no mention of the lesions in the impression. My liver labs are normal and had negative colonoscopy 1 yr ago with normal CBC. Since the lesions aren’t mentioned in impression I’m optimistic but wondered about the lesions plural followed by a : and singular cyst. Again thanks for all you doDan
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Follow up: Dr. Vivek Chail (0 minute later)
Thank you! XXXXXXX showed no gallstones but my liver showed focal liver lesions:small cyst with no mention of the lesions in the impression. My liver labs are normal and had negative colonoscopy 1 yr ago with normal CBC. Since the lesions aren’t mentioned in impression I’m optimistic but wondered about the lesions plural followed by a : and singular cyst. Again thanks for all you doDan
doctor
Answered by Dr. Vivek Chail (4 hours later)
Brief Answer:
Small cysts are usually a benign finding

Detailed Answer:
Hi,
Thanks for the updates.

A liver lesion less than 15 mm is not easy to characterise however in most cases cysts are usually simple benign cysts and not a cause for any concern. Also your liver function tests are normal.

Regarding the gall stones, there are no obvious gall stones in the MRCP and therefore the previous test showing doubtful gall stones might be a false positive.

I would suggest trying to get a follow up ultrasound scan of the liver done in 3 to 6 months to know any changes in the cysts and to look for any gall stones once again.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
Small cysts are usually a benign finding

Detailed Answer:
Hi,
Thanks for the updates.

A liver lesion less than 15 mm is not easy to characterise however in most cases cysts are usually simple benign cysts and not a cause for any concern. Also your liver function tests are normal.

Regarding the gall stones, there are no obvious gall stones in the MRCP and therefore the previous test showing doubtful gall stones might be a false positive.

I would suggest trying to get a follow up ultrasound scan of the liver done in 3 to 6 months to know any changes in the cysts and to look for any gall stones once again.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (8 hours later)
Thanks! Just to be clear my mrcp(previously misspelled) showed the focal liver lesions. I assume these are too hard to characterize even on mrcp with contrast and I should follow-up with US. Would mrcp or mri be better since US didn’t show these lesions on 10/24/19? What about a different type of US? Thank you!
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Follow up: Dr. Vivek Chail (0 minute later)
Thanks! Just to be clear my mrcp(previously misspelled) showed the focal liver lesions. I assume these are too hard to characterize even on mrcp with contrast and I should follow-up with US. Would mrcp or mri be better since US didn’t show these lesions on 10/24/19? What about a different type of US? Thank you!
doctor
Answered by Dr. Vivek Chail (47 minutes later)
Brief Answer:
Using MRCP images, an attempt can be made on ultrasound scan

Detailed Answer:
Hi,
Thanks for writing back with an update.

Ultrasound is an effective method to follow up liver lesions as a doctor may not order MRCP unless essential. Ultrasound is a skilled technique and an attempt can be done to look for the lesions on ultrasound by using the MRCP images as a guidance. If still not visualised then a MRCP can be done.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
Using MRCP images, an attempt can be made on ultrasound scan

Detailed Answer:
Hi,
Thanks for writing back with an update.

Ultrasound is an effective method to follow up liver lesions as a doctor may not order MRCP unless essential. Ultrasound is a skilled technique and an attempt can be done to look for the lesions on ultrasound by using the MRCP images as a guidance. If still not visualised then a MRCP can be done.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vivek Chail (12 hours later)
Hello again and thank you,
Would a hidascan show anything that wouldn't be visualized on mrcp? And would you think the neg mrcp is superior to the positive US? Sorry to string this out but I'm almost there. XXXXXXX
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Follow up: Dr. Vivek Chail (0 minute later)
Hello again and thank you,
Would a hidascan show anything that wouldn't be visualized on mrcp? And would you think the neg mrcp is superior to the positive US? Sorry to string this out but I'm almost there. XXXXXXX
doctor
Answered by Dr. Vivek Chail (4 hours later)
Brief Answer:
HIDA is a functional scan

Detailed Answer:
Hi,
Thanks for writing in with an update.

MRCP is an investigation to get a clear look at the structure of the liver and biliary tree and a HIDA scan is used to get better functional information.

So the investigations are complimentary but HIDA is done only if there are indications of biliary tree dysfunction on MRCP.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vivek Chail (0 minute later)
Brief Answer:
HIDA is a functional scan

Detailed Answer:
Hi,
Thanks for writing in with an update.

MRCP is an investigation to get a clear look at the structure of the liver and biliary tree and a HIDA scan is used to get better functional information.

So the investigations are complimentary but HIDA is done only if there are indications of biliary tree dysfunction on MRCP.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

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Hello, Which Test Would Be Better For Ruling Out Gallbladder

Hello, Which test would be better for ruling out gallbladder cancer, mri-abdomen or MCRP? Thanks!