Bile duct obstruction and choledocholithiasis: diagnosis with MR cholangiography.
OBJECTIVE
To evaluate the accuracy of magnetic resonance (MR) cholangiopancreatography in the diagnosis of bile duct obstruction.


METHODS
One hundred twenty-six patients with clinically suspected bile duct obstruction underwent MR cholangiopancreatography with heavily T2-weighted fast spin-echo sequences. Reviewers were blinded to clinical and imaging findings.


RESULTS
Seventy-nine patients had biliary obstruction that was diagnosed with MR cholangiopancreatography in 72 patients for a sensitivity of 91%, specificity of 100%, and overall accuracy of 94%. Thirty-two patients had choledocholithiasis that was diagnosed with MR cholangiopancreatography in 26 patients for an accuracy of 94%, sensitivity of 81%, specificity of 98%, positive predictive value of 93%, and negative predictive value of 94%. Fourteen patients had malignant obstruction that was diagnosed with MR cholangiopancreatography in 12 patients for a sensitivity and a positive predictive value of 86%, specificity and negative predictive value of 98%, and accuracy of 97%.


CONCLUSIONS
MR cholangiopancreatography is a noninvasive technique with excellent accuracy in the diagnosis of bile duct obstruction and its causes.
Guibaud
L
L
Department of Diagnostic Radiology, Montreal General Hospital, McGill University, Quebec, Canada.
Bret
P M
PM
Reinhold
C
C
Atri
M
M
Barkun
A N
AN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications; D001653:Bile Ducts, Intrahepatic; D002648:Child; D018281:Cholangiocarcinoma / Q000150:complications; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications