If the majority of authors report underestimation errors in the evaluation of longitudinal diffusion, others  report a high rate of overestimation due to peritu-moral fibrosis. Comparing the data of ERCP, PTC, and MRCP with surgical specimens the German authors report a correct evaluation with ERCP in 29% of the cases, with MRCP in 36%, and with PTC in 53%, an overestimation rate of 42,41 and 31%, and underestimation rate of 31, 23 and 16%, respectively. In the experience of these authors the most reliable technique for studying hilar cholangiocarcinoma is PTC: significantly better than ERCP (p<0.008), slightly superior to MRCP (p=0.06), while ERCP and MRCP have similar results. The limit of ERCP is the evaluation of proximal extension of the tumour, determined by the absent or incomplete opacification of the intrahepatic biliary tree. MRCP, conversely, allows a correct image of both the hepatic lobes in about 90% of cases, while it has a lower ability than PTC (p<0.019) to evaluate the edges of the neoplasm. The main diagnostic problems concern stages III and IV of Bismuth-Corlette, which are better studied with PTC than ERCP or MRCP.
Was this article helpful?