[Cholangiography with magnetic resonance in the diagnosis of main common bile duct calculi in candidates to laparoscopic cholecystectomy].
The aim of our work was to investigate Magnetic Resonance Cholangiography (MRC) capabilities in detecting common bile duct (CBD) stones in patients to be submitted to laparoscopic cholecystectomy. MRC was performed as the only preoperative imaging modality in 45 selected patients (16 men and 29 women; age range: 28-72 years, mean age: 54.4 years) before laparoscopic cholecystectomy. MRC images were obtained with 3D Turbo Spin-Echo sequences (TR = 3000 ms, TE = 700 ms, echo train length = 128) with an acquisition time of 5 min 48 sec. Diagnostic confirmation was obtained in all the patients at intraoperative cholangiography. When a stone was detected, it was removed by transcystic or transcholedochal approach. Eighteen of 45 patients (40%) had CBD stones. MRC correctly demonstrated 16 of 18 stones, with 88.9% sensitivity, 100% specificity, 100% positive predictive value, 90% negative predictive value and 95.6% accuracy. Despite the good results we obtained with MRC, this technique cannot be proposed as a screening method to be performed in all the patients candidate to laparoscopic cholecystectomy because of its high cost and of the limited number of MR units available. In conclusion, only selected patients should be submitted to MRC before laparoscopic cholecystectomy.
Pavone
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P
Dipartimento di Radiologia, II Cattedra, Università La Sapienza, Roma.
Laghi
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A
Catalano
C
C
Panebianco
V
V
Messina
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A
Pirillo
S
S
Fanelli
F
F
Passariello
R
R
D000328:Adult; D000368:Aged; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D042882:Gallstones / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity