Choledocholithiasis and bile duct stenosis: diagnostic accuracy of MR cholangiopancreatography.
OBJECTIVE
To evaluate the accuracy of magnetic resonance (MR) cholangiopancreatography for detecting bile duct calculi and stenosis.


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).


CONCLUSIONS
With MR cholangiopancreatography, bile duct calculi and stenoses can be diagnosed with high accuracy and good interobserver agreement.
Becker
C D
CD
Department of Radiology, University Hospital, Geneva, Switzerland.
Grossholz
M
M
Becker
M
M
Mentha
G
G
de Peyer
R
R
Terrier
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis; D001652:Bile Ducts / Q000473:pathology; D002675:Child, Preschool; D002779:Cholestasis / Q000175:diagnosis* / Q000209:etiology; D003251:Constriction, Pathologic; D005260:Female; D042882:Gallstones / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity