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MR Cholangiography in Symptomatic Gallstones: Diagnostic Accuracy according to Clinical Risk Group

 Joo Hee Kim  ;  Myeong-Jin Kim  ;  Sung Il Park  ;  Jae-Joon Chung  ;  Si Young Song  ;  Kyung Sik Kim  ;  Hyung Sik Yoo  ;  Jong Tae Lee  ;  Ki Whang Kim 
 RADIOLOGY, Vol.224(2) : 410-416, 2002 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Ducts/pathology ; Diagnostic Errors ; Female ; Gallstones/diagnosis* ; Humans ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Risk Factors ; Sensitivity and Specificity
PURPOSE: To determine the diagnostic accuracy of magnetic resonance (MR) cholangiography in the detection of common bile duct (CBD) stones in patients with symptomatic gallstones.

MATERIALS AND METHODS: Single-shot half-Fourier MR cholangiographic images were obtained in 121 consecutive patients who were referred for MR cholangiography prior to cholecystectomy for symptomatic gallstones. One radiologist interpreted the MR cholangiographic images without prior knowledge of laboratory test results or findings from examinations with other imaging modalities. Patients were retrospectively divided into three groups with high, moderate, and low risk (n = 70, 22, and 29, respectively) for CBD stones. The sensitivity, specificity, and accuracy of MR cholangiography in the detection of CBD stones in each group were calculated. The accuracy of laboratory and sonographic findings in the identification of CBD stones was also calculated.

RESULTS: CBD stones were diagnosed in 49 (70%) of 70 patients in the high-risk group. One false-positive diagnosis was made, and two false-negative diagnoses were made. Of the 22 patients in the moderate-risk group, seven (32%) had CBD stones, and there was one false-positive and one false-negative diagnosis. In the low-risk group, CBD stones were correctly identified with MR cholangiography in one patient, and there was one false-positive diagnosis. A combination of positive laboratory and sonographic findings yielded a sensitivity of 98% but a specificity of only 34% if any unusual finding in any one of the tests was regarded as a positive finding.

CONCLUSION: MR cholangiography is highly accurate in the detection of CBD stones in all patients, regardless of the grade of risk, and should be considered in patients with a moderate to high risk of CBD stones before cholecystectomy.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Park, Sung Il(박성일)
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Yoo, Hyung Sik(유형식)
Lee, Jong Tae(이종태)
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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