Becker CD, Grossholz M, Becker M, Mentha G, de Peyer R, Terrier F. Choledocholithiasis and bile duct stenosis: diagnostic accuracy of MR cholangiopancreatography.Radiology 1997 Nov;205(2):523-30
Department of Radiology, University Hospital, Geneva, Switzerland.
PURPOSE: To evaluate
the accuracy of magnetic resonance (MR) cholangiopancreatography
for detecting bile duct calculi and stenosis. MATERIALS AND METHODS:
At MR cholangiopancreatography, 108 patients suspected of having
bile duct calculi or stenosis were examined with two-dimensional
fast spin-echo MR sequences and respiratory gating. On the basis
of findings at surgery and/or intraoperative, endoscopic retrograde,
and/or percutaneous cholangiography, final diagnoses were normal
bile ducts (n = 38), choledocholithiasis (n = 23), Mirizzi syndrome
(n = 3), benign or malignant bile duct stenosis (n = 40), choledochal
cyst (n = 1), and bile duct dilatation without calculi or stenosis
(n = 3). MR cholangiopancreatographic images were analyzed retrospectively
by three reviewers who were unaware of final diagnoses. RESULTS:
Choledocholithiasis was diagnosed with a sensitivity of 88%-92%
and a specificity of 91%-98%. False-negative readings occurred
because small or impacted calculi at the distal common bile duct
or ampulla were difficult to detect or distinguish from stenosis.
Bile duct stenosis was diagnosed with a sensitivity of 93%-100%
and a specificity of 98%. Presence or absence of bile duct abnormality
was assessed with a sensitivity of 97%-99% and a specificity of
95%-97%. Interobserver agreement was very good (kappa = 0.86-0.96).
CONCLUSION: With MR cholangiopancreatography, bile duct calculi
and stenoses can be diagnosed with high accuracy and good interobserver
agreement.
| Dilatation | Calcul |