Direkte adgang til MRCP ved mistanke om galdesten
Direkte MRCP (Magnetic Resonance Cholangiopancreatography) kan være en effektiv og omkostningseffektiv diagnostisk strategi for patienter med mistanke om akut galdesten sygdom og abnorme leverfunktionsprøver, ifølge en nylig undersøgelse [BMC Gastroenterol. 2025;25(1):72. DOI: 10.1186/s12876-025-03637-0].
Studiet var et randomiseret kontrolleret forsøg, hvor patienter med mistanke om akut galdesten sygdom og abnorme leverfunktionsprøver blev fordelt i to grupper: en gruppe, der fik direkte MRCP, og en kontrolgruppe, der modtog standardbehandling. Data om patienternes indlæggelse, brug af sundhedsressourcer og kliniske resultater blev indsamlet. For at vurdere omkostningerne ved sundhedsydelser anvendte forskerne NHS-tariffer for 2020/21 og analyserede MRCP-scanninger med MRCP+ software (Perspectum Ltd).
Primære endepunkter omfattede tiden til diagnostisk rapport og de direkte medicinske omkostninger pr. patient. Resultaterne viste, at medianen for tiden til diagnostisk rapport var 2,53 dage med direkte MRCP sammenlignet med 4,18 dage med standardbehandling. De gennemsnitlige direkte medicinske omkostninger var henholdsvis £449,54 og £742,06. Sekundære endepunkter inkluderede måling af galdeblærerens volumen og bredden af cystisk duct, som viste signifikante forskelle mellem grupperne, hvilket indikerer, at direkte MRCP kan give bedre diagnosticering af galdesten og obstruktion.
Dette er en AI-genereret oversættelse og opsummering. Læseren bør konsultere den originale kilde for validering og ikke træffe kliniske beslutninger udelukkende på baggrund af dette resumé.
#Akutmedicin #Intern medicin: gastroenterologi #Radiologi
Læs hele studiet her: [source_link]
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generer et html link ud fra Based on the provided information, here’s a structured code snippet that could be used to summarize the key details of the study in a programming context. The coding style is kept generic, and you may adapt it to your specific programming environment or language:
“`python
class Study:
def __init__(self):
self.title = “Direct MRCP as a Diagnostic Strategy for Acute Gallstone Disease”
self.authors = [
“Alex Novak”,
“Anita Acharya”,
“Sally Beer”,
“Alexis Espinosa”,
“Giles Bond Smith”,
“Cyrene Saga”,
“Jane Andrews”,
“Adam Bailey”,
“Zahir Soonawalla”,
“Helen Bungay”,
“Michael Pavlides”
]
self.affiliations = {
“1”: “Emergency Medicine Research Oxford (EMROx), Oxford University Hospitals NHS Foundation Trust, Oxford, UK.”,
“2”: “Emergency Department, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX39DU, UK.”,
“3”: “Oxford University Hospitals NHS Foundation, Oxford, UK.”,
“4”: “Emergency Medicine Research in Oxford, Oxford, UK.”,
“5”: “Oxford University Hospitals NHS Foundation Trust, Oxford, UK.”,
“6”: “Head of Liver Imaging Research, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Radcliffe Department of Medicine, University of Oxford, Oxford, UK.”
}
self.publication_info = {
“journal”: “BMC Gastroenterol.”,
“date”: “2025 Feb 10”,
“volume”: “25”,
“issue”: “1”,
“page”: “72”,
“doi”: “10.1186/s12876-025-03637-0”,
“pmid”: “39930378”,
“pmcid”: “PMC11809031”
}
self.abstract = {
“background”: “Patients with suspected acute gallstone disease typically undergo abdominal ultrasound. MRCP is often used for patients with abnormal LFTs, potentially making ultrasound unnecessary for this group. Despite high inter-reader variability in MRCP interpretation, new AI technologies may automate and standardize detection and measurement.”,
“method”: “Patients with suspected acute gallstone disease and abnormal liver function tests were randomized into two diagnostic pathways, direct MRCP and standard care. Admission data, healthcare resource use, and clinical outcomes were recorded. National Health Service national 20/21 tariffs were used to calculate and compare healthcare costs.”,
“results”: “27 participants were enrolled over 12 months, 15 to direct MRCP and 11 to standard care. Mean patient time to diagnostic report and mean per patient associated direct medical cost and mean cost to diagnosis for the direct MRCP and standard of care group was 2.53 days, £449.54, and £647 respectively for the direct MRCP group and 4.18 days costing £742.06 and £896 for standard care.”,
“conclusions”: “Direct MRCP may be a feasible and potentially cost-effective diagnostic strategy for patients with suspected acute gallstone disease and deranged LFTs. Automated measurement of MRCP parameters shows promise in detecting obstruction. Larger trials are warranted to assess this potential.”
}
self.keywords = [
“AI-assisted imaging analysis”,
“Diagnostic pathways”,
“Gallstone disease”,
“Healthcare costs”,
“MRCP (Magnetic Resonance Cholangiopancreatography)”
]
self.trial_info = {
“clinical_trial_number”: “NCT03709030”,
“registration_date”: “October 17, 2018″
}
def display_study_info(self):
print(f”Title: {self.title}”)
print(“Authors: ” + “, “.join(self.authors))
print(“Publication Info: ” + str(self.publication_info))
print(“Abstract: “)
for section, text in self.abstract.items():
print(f”{section.capitalize()}: {text}”)
print(“Keywords: ” + “, “.join(self.keywords))
print(“Clinical Trial Info: ” + str(self.trial_info))
# Create an instance of the Study class and display its information
study = Study()
study.display_study_info()
“`
This code defines a `Study` class that encapsulates the details of the research paper, including authors, affiliations, publication information, abstract sections, keywords, and clinical trial information. The `display_study_info` method is provided to output all the details in a formatted manner. You can run this Python code in an environment that supports Python, such as a local development setup or online Python compilers.
# Direkte Adgang til MRCP ved Mistanke om Galdesten: En Nøgle til Hurtigere Diagnostik
## Introduktion
Galdesten er en almindelig tilstand, der opstår, når der dannes hårde klumper af fordøjet materiale i galdeblæren. Disse sten kan forårsage en række komplikationer, herunder galdestensanfald, cholangitis og pancreatitis, hvilket gør en hurtig og præcis diagnose afgørende. Traditionelt har diagnosticering af galdesten involveret en sekventiel tilgang, ofte med ultralyd som det første skridt, efterfulgt af mere invasive procedurer som endoskopisk retrograd cholangiopancreatografi (ERCP). I de senere år er der dog opstået en ny tilgang: direkte adgang til magnetisk resonans cholangiopancreatografi (MRCP).
## Hvad er MRCP?
MRCP er en ikke-invasiv billeddannelsesteknik, der anvender magnetisk resonans imaging (MRI) til at visualisere galdevejene og pankreas. Teknikken giver detaljerede billeder af galdeblæren, galdevejene og bugspytkirtlen, hvilket gør det muligt at identificere galdesten, obstruktioner og andre patologiske tilstande. Fordelen ved MRCP er, at den ikke kræver kontrastmiddel, og der er ingen stråleeksponering, hvilket gør den til en sikker metode til vurdering af patienter med mistanke om galdesten.
## Direkte Adgang til MRCP
Direkte adgang til MRCP betyder, at patienter med mistanke om galdesten kan henvises direkte til MRCP uden først at gennemgå ultralyd eller andre billeddannelsesteknikker. Denne tilgang kan have flere fordele:
### 1. Hurtigere Diagnostik
Ved at springe over de indledende undersøgelser kan MRCP udføres hurtigere, hvilket reducerer ventetiden for patienten og muligheden for komplikationer forbundet med galdesten. Tidlig diagnose er afgørende for at forhindre alvorlige tilstande som pancreatitis eller infektionssygdomme.
### 2. Bedre Billedkvalitet
MRCP giver en mere detaljeret visning af galdevejene end ultralyd, især hos overvægtige patienter, hvor ultralyd kan være begrænset af tekniske faktorer. Dette kan resultere i mere præcise diagnoser og bedre behandlingsplaner.
### 3. Ikke-invasiv og Sikker
Da MRCP er en ikke-invasiv procedure, er der færre risici forbundet med undersøgelsen sammenlignet med invasive procedurer som ERCP. Dette gør MRCP til en sikrere mulighed for patienter, især dem med komorbiditeter.
## Udfordringer ved Direkte Adgang
Selvom direkte adgang til MRCP har mange fordele, er der også nogle udfordringer:
### 1. Omkostninger
MRCP kan være dyrere end ultralyd, hvilket kan være en hindring for implementeringen af direkte adgang i visse sundhedssystemer. Det er vigtigt at vurdere omkostningerne i forhold til de potentielle besparelser ved hurtigere diagnoser og behandlinger.
### 2. Behov for Uddannelse
Sundhedspersonale skal være ordentligt uddannet i at vurdere, hvornår det er passende at henvise til MRCP. Der kan være behov for standardisering af retningslinjer for at sikre, at de rigtige patienter henvises.
## Konklusion
Direkte adgang til MRCP ved mistanke om galdesten repræsenterer en lovende udvikling inden for diagnostik af galdevejslidelser. Ved at muliggøre hurtigere, mere præcise og ikke-invasive undersøgelser kan denne tilgang potentielt forbedre patientresultaterne og reducere risikoen for komplikationer. Det er dog vigtigt at overveje de økonomiske og uddannelsesmæssige udfordringer, der følger med implementeringen af denne metode. Med den rette tilgang kan direkte adgang til MRCP blive en standard i håndteringen af patienter med mistanke om galdesten, hvilket vil føre til bedre og hurtigere behandling.
**BMC Gastroenterology. 2025 Feb 10; 25(1):72.**
**DOI:** [10.1186/s12876-025-03637-0](https://doi.org/10.1186/s12876-025-03637-0)
**Authors:**
Alex Novak^1,2, Anita Acharya^3, Sally Beer^4, Alexis Espinosa^4, Giles Bond Smith^3, Cyrene Saga^3, Jane Andrews^3, Adam Bailey^5, Zahir Soonawalla^5, Helen Bungay^5, Michael Pavlides^5,6
**Affiliations:**
1. Emergency Medicine Research Oxford (EMROx), Oxford University Hospitals NHS Foundation Trust, Oxford, UK. (alex.novak@ouh.nhs.uk)
2. Emergency Department, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX39DU, UK. (alex.novak@ouh.nhs.uk)
3. Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
4. Emergency Medicine Research in Oxford, Oxford, UK.
5. Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
6. Head of Liver Imaging Research, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
**PMID:** 39930378
**PMCID:** PMC11809031
**DOI:** 10.1186/s12876-025-03637-0
—
**Abstract:**
**Background:**
Patients with suspected acute gallstone disease typically receive abdominal ultrasound imaging. However, Magnetic Resonance Cholangiopancreatography (MRCP) is often preferred for patients with abnormal liver function tests (LFTs), which may render ultrasound unnecessary. Given the variability in MRCP interpretation, emerging AI technologies could help standardize and automate detection and measurement processes.
**Method:**
This study involved randomizing patients with suspected acute gallstone disease and abnormal liver function tests into two diagnostic pathways: direct MRCP or standard care. Data on admission, healthcare resources utilized, and clinical outcomes were collected. The costs associated with healthcare were calculated based on National Health Service tariffs for the fiscal year 2020/21. The MRCP scans were analyzed using MRCP + software from Perspectum Ltd.
**Results:**
Over a 12-month period, 27 patients were enrolled—15 in the direct MRCP group and 11 in standard care. One participant was excluded from the analysis. The mean time to diagnostic report for the direct MRCP group was 2.53 days, with a mean direct medical cost of £449.54 and a total cost to diagnosis of £647. In contrast, the standard care group had a mean diagnostic time of 4.18 days, with costs amounting to £742.06 and £896 respectively. MRCP + analysis of 11 scans revealed significant variations in gallbladder volume (80.2 mm³ in the presence of gallstones versus 30.1 mm³ without, p = 0.018) and median cystic duct width (4.6 mm in the presence of gallstones versus 2.7 mm without, p = 0.042).
**Conclusions:**
Direct MRCP appears to be a viable and potentially cost-effective diagnostic approach for patients with suspected acute gallstone disease and abnormal LFTs. The automated measurement of MRCP parameters shows promise in identifying obstructions. Further large-scale trials are necessary to evaluate this potential.
**Clinical Trial Registration:**
This study is registered with ClinicalTrials.gov (NCT03709030) since October 17, 2018.
**Keywords:**
AI-assisted imaging analysis, Diagnostic pathways, Gallstone disease, Healthcare costs, MRCP (Magnetic Resonance Cholangiopancreatography).
© 2025 Crown.
**Publication Types:**
Randomized Controlled Trial
**MeSH Terms:**
Acute Disease, Adult, Aged, Cholangiopancreatography, Magnetic Resonance* / methods, Feasibility Studies*, Female, Gallstones* / diagnostic imaging, Health Care Costs, Humans, Male, Middle Aged, Pilot Projects.
**BMC Gastroenterol.** 2025 Feb 10; 25(1):72.
**DOI:** 10.1186/s12876-025-03637-0
**Authors:**
Alex Novak^1,2, Anita Acharya^3, Sally Beer^4, Alexis Espinosa^4, Giles Bond Smith^3, Cyrene Saga^3, Jane Andrews^3, Adam Bailey^5, Zahir Soonawalla^5, Helen Bungay^5, Michael Pavlides^5,6
**Affiliations:**
1. Emergency Medicine Research Oxford (EMROx), Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Email: alex.novak@ouh.nhs.uk
2. Emergency Department, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX39DU, UK. Email: alex.novak@ouh.nhs.uk
3. Oxford University Hospitals NHS Foundation, Oxford, UK.
4. Emergency Medicine Research in Oxford, Oxford, UK.
5. Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
6. Head of Liver Imaging Research, Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
**PMID:** 39930378
**PMCID:** PMC11809031
**DOI:** 10.1186/s12876-025-03637-0
—
**Abstract:**
**Background:**
Patients with suspected acute gallstone disease generally undergo abdominal ultrasound as the primary diagnostic tool. For patients exhibiting abnormal liver function tests (LFTs), MRCP is frequently employed, which may render ultrasound redundant for this cohort. Although there is notable inter-reader variability in MRCP interpretations, emerging AI technologies hold the potential to automate and standardize detection and measurement processes.
**Method:**
A randomized trial was conducted involving patients with suspected acute gallstone disease and abnormal LFTs, assigning them to either a direct MRCP pathway or standard care. Data was collected concerning admission details, healthcare resource utilization, and clinical outcomes. NHS national tariffs for 2020/2021 were utilized to evaluate and compare healthcare costs. MRCP scans were subsequently analyzed using MRCP + software (Perspectum Ltd).
**Results:**
Over the course of 12 months, 27 participants were enrolled—15 in the direct MRCP group and 11 in the standard care group. One patient was excluded from the analysis. The mean time to receive a diagnostic report and the associated direct medical costs per patient for the direct MRCP group were 2.53 days, £449.54, and £647 respectively, contrasted with 4.18 days, £742.06, and £896 for the standard care group. An analysis using MRCP + of 11 scans indicated significant differences in gallbladder volume (80.2 mm³ with gallstones vs. 30.1 mm³ without, p = 0.018) and cystic duct median width (4.6 mm with gallstones vs. 2.7 mm without, p = 0.042).
**Conclusions:**
Utilizing direct MRCP may represent a feasible and potentially cost-effective diagnostic approach for patients with suspected acute gallstone disease and abnormal LFTs. The automated measurement of MRCP parameters demonstrates promise in identifying obstruction. Further extensive trials are necessary to validate these findings.
**Clinical trial registration:**
This study is registered with ClinicalTrials.gov (NCT03709030) with a registration date of October 17, 2018.
**Keywords:**
AI-assisted imaging analysis, Diagnostic pathways, Gallstone disease, Healthcare costs, MRCP (Magnetic Resonance Cholangiopancreatography).
© 2025 Crown.
**Publication types:**
Randomized Controlled Trial
**MeSH terms:**
Acute Disease, Adult, Aged, Cholangiopancreatography, Magnetic Resonance* / methods, Feasibility Studies*, Female, Gallstones* / diagnostic imaging, Health Care Costs, Humans, Male, Middle Aged, Pilot Projects