Choledocholithiasis: evaluation of MR cholangiography for diagnosis.
OBJECTIVE
To evaluate the test performance of magnetic resonance (MR) cholangiography for help in diagnosing choledocholithiasis.


METHODS
Fast spin-echo MR cholangiography was performed by using a torso multicoil array in 110 patients suspected of having bile duct obstruction. Axial and coronal images were reviewed by two observers who were blinded to results of direct cholangiography and final diagnoses. The final diagnosis was established by using direct cholangiographic (n = 103) or surgical (n = 7) findings.


RESULTS
Of the 110 patients, 30 (27%) had choledocholithiasis, and 80 (73%) did not. Reviewer 1 used MR cholangiograms to achieve a sensitivity of 90%, specificity of 100%, positive predictive value of 100%, negative predictive value of 96%, and overall accuracy of 97%. Reviewer 2 achieved a sensitivity of 90%, specificity of 93%, positive predictive value of 82%, negative predictive value of 96%, and overall accuracy of 92%. Interobserver agreement for MR cholangiograms was 93% (kappa = 0.82).


CONCLUSIONS
MR cholangiography exhibited excellent test performance and resulted in excellent interobserver agreement for the diagnosis of choledocholithiasis.
Reinhold
C
C
Department of Diagnostic Radiology, Montreal General Hospital, Quebec, Canada.
Taourel
P
P
Bret
P M
PM
Cortas
G A
GA
Mehta
S N
SN
Barkun
A N
AN
Wang
L
L
Tafazoli
F
F
D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000453:epidemiology; D003135:Common Bile Duct / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005260:Female; D042882:Gallstones / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity