Choledocholithiasis: evaluation of MR cholangiography for diagnosis.

Reinhold, Caroline; Taourel, Patrice; Bret, Patrice M.; Cortas, George; Mehta, Saurabh; Barkun, Alan N.; Wang, L; Tafazoli, Faranak

doi:10.1148/radiology.209.2.9807570

Cited by 139 publications

(71 citation statements)

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“…This relatively new diagnostic procedure which involves capturing a heavily T2 weighted image (which enhances fl uid containing structures) is rapidly gaining acceptance [12][13][14][15][16][17][18][19][20][21][22][23]. The reasons for this are (i) It is non-invasive (ii) It simultaneously gives considerable information regarding adjacent structures such as the pancreas and liver (iii) Allows for 3 dimensional reconstruction (iv) Combined with Gadolinium enhanced MR angiography forms a complete single investigation (v) Can replace intraoperative cholangiogram once experience at interpretation improves (vi) Shares the same disadvantages as ERCP in that it cannot differentiate between stone, sludge, mucus plugs…”

Section: Mrcp (Magnetic Resonance Cholangiopancreatogram)mentioning

confidence: 99%

“…Choledocholithiasis can be diagnosed with a sensitivity of 88-92% and specifi city of 91-98% (vs. 98% for ERCP) [12][13][14][15][16][17][18][19][20][21][22][23]. In a blinded study with 110 patients, 30 with choledocholithiasis, 2 observers, one of whom had an experience of 2 years, achieved comparable results with a sensitivity of 90%, specifi city of 93%, positive predictive value of 82%, and negative predictive value of 96% and overall accuracy of 92% with inter-observer agreement of 93% [21].…”

Section: Mrcp (Magnetic Resonance Cholangiopancreatogram)mentioning

confidence: 99%

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Common bile duct stones — their presentation, diagnosis and management

Desai¹,

Shokouhi

2009

Indian J Surg

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Common bile duct (CBD) stones continue to pose a signifi cant problem both to the patient and the surgeon. They increase the morbidity of a patient undergoing Cholecystectomy from less than 5% to as much as 20% and almost zero mortality to as high as 30%. Recent times have thrown up a fair share of controversy in the management of this condition both due to technological innovations and costreduction-pressures. The aim in CBD stone disease, as in any benign disease is to discover a therapeutic algorithm with minimal morbidity, no mortality and at reasonable cost. This can be achieved only by a thorough understanding of the disease and also the available diagnostic and treatment modalities.This article dicusses the diagnosis, investigation and therapy of CBD stones and gives a therapeutic algorithm.

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Section: Mrcp (Magnetic Resonance Cholangiopancreatogram)mentioning

confidence: 99%

Section: Mrcp (Magnetic Resonance Cholangiopancreatogram)mentioning

confidence: 99%

Common bile duct stones — their presentation, diagnosis and management

Desai¹,

Shokouhi

2009

Indian J Surg

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“…A CPRM teve sensibilidade de 89% e especificidade de 67%. Os achados mostram valores próximos de sensibilidade aos descritos na literatura em análise de grandes séries, variando de 85% a 100% (1,2,4,6,9,11,14,16,20,26,28) . Entretanto, os valores de especificidade observados no presente estudo, discordam dos apresentados por outros autores.…”

Section: Tabela 4 -unclassified

“…Os mesmos autores sugeriram que a sensibilidade da CPRM diminui bastante no diagnóstico de cálculos com menos de 4 mm. Entretanto, alguns fatores podem interferir, como aqueles ligados ao tipo de técnica e equipamento empregado (26) .…”

Section: Dos 41 Pacientes Estudados 17 (41%) Apresentavam Cálculos (unclassified

Estudo comparativo entre a colangiopancreatografia por ressonância magnética e a colangiopancreatografia endoscópica no diagnóstico das obstruções biliopancreáticas

Pisani

Bacelar²,

Malafaia

et al. 2001

Arq. Gastroenterol.

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“…La sensibilidad y el valor predictivo positivo (VPP) del ultrasonido en el diagnóstico de coledocolitiasis antes de la cirugía varía según autores y equipamiento, siendo inferior al de la Colangiorresonancia (CPRM) y al de la Colangiografía endoscópica retrograda (ERCP); sin embargo su especificidad es bastante similar a estas dos modalidades diagnósticas. Por otra parte, su uso, se asocia a rapidez, ausencia de radiación y bajo costo (1)(2)(3) .…”

Section: Introductionunclassified

Colangioresonancia (Cprm) vs Ultrasonido (Us) Focalizado en Pacientes Con Ictericia O Sospecha De Obstruccion De La via Biliar: Resultados Preliminares

M¹,

M²,

P³

et al. 2003

Rev. chil. radiol.

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Between January and July, 2003, a single blinded matched trial was done to assess focalized biliary ultrasound (US) and MR cholangiography (MRCP) compared with ERCP or surgery as reference standard in patients with suspected biliary obstruction. Focalized US was performed 24 hrs before/after MRCP. Patients were triage according symptoms, signs and laboratory in high, intermediate and low risk for obstruction. Radiologists sonographers were divided in low and highly experienced. None of the radiologist who reported either US or MRCP was aware to the other test results. Sensitivity, Specificity, PPV and NPV, (LR) Likelihood Ratios and pre and post-test odds for positive and negative test were estimated.We analized 64 out of 76 sampled patients, the prevalence of obstruction was 37 % (24 out of 64 patients). US found biliary tree dilated in 50% and MRCP in 48% of the patients. Main cause of obstruction was common bile duct stones in (16) 25%. and tumors were the second more common cause. US shown a Sensitivity (S) 58.3% when a non experienced radiologist perform the exam, and 70% when an experienced radiologist doest it. Specificity (Sp) 82,5%, PPV 66.7% and NPV 76.7%. RMCP Shown S 95.8%, Sp 87.5%, PPV 82.1%, NPV 97.2% For common bile duct stones US shown a PPV 53.3% and NPV 83.6% on the other hand MRCP a PPV 70% and NPV 95.4%. MRCP perform better than focalized US in overall patients with high risk of obstruction (37.5%), detecting the cause of obstruction but using aditional sequences rising the examination time and costs. With a positive ultrasound and LR(+) 3.3 pretest odds rise from 0.37/37% to a post-test odds of 0.55/55% and with negative test result and LR(-) 0.49 pre-test odds 0.37/37% will decrease to post-test odds of 0.2/20%. With MRCP a positive test with LR(+) 7.7 initial pre-test odds 0.37/37.5% to post-test odds of 0.8/ 80% and with a negative test result LR(-) 0.05 pretest odds 0.37/37% will decrease to post-test odds of 0.03%.Ultrasound performed by experienced sonographers has a Specificity and NPV over 80%, and perform similar to MRCP for detecting biliary tree dilatation the best predictor of obstruction. In patients with low pre-test odds (low risk) of obstruction, to use focalized US and then MRCP, when the cause of obstruction is not diagnosed could be the more cost/ efective initial alternative in this patients. This data must be confirmed with further studies with cost/effectivenes analysis.

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Choledocholithiasis: evaluation of MR cholangiography for diagnosis.

Abstract: MR cholangiography exhibited excellent test performance and resulted in excellent interobserver agreement for the diagnosis of choledocholithiasis.

Cited by 139 publications

References 0 publications

Common bile duct stones — their presentation, diagnosis and management

Common bile duct stones — their presentation, diagnosis and management

Estudo comparativo entre a colangiopancreatografia por ressonância magnética e a colangiopancreatografia endoscópica no diagnóstico das obstruções biliopancreáticas

Colangioresonancia (Cprm) vs Ultrasonido (Us) Focalizado en Pacientes Con Ictericia O Sospecha De Obstruccion De La via Biliar: Resultados Preliminares

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