The efficacy of magnetic resonance cholangiography for the evaluation of patients with suspected choledocholithiasis before laparoscopic cholecystectomy.
BACKGROUND
Endoscopic retrograde cholangiography is the most commonly utilized tool for the identification of common bile duct stones (CBDS) before laparoscopic cholecystectomy, whereas the role of magnetic resonance cholangiography (MRC) for patient evaluation before laparoscopic cholecystectomy is currently undefined.


METHODS
We prospectively evaluated the efficacy of MRC for the identification of CBDS among patients with high risk for choledocholithiasis. Patient selection was based on clinical, sonographic, and laboratory criteria. Standard cholangiograms were obtained when possible for verification of MRC results.


RESULTS
Ninety-nine patients underwent evaluation with preoperative MRC. CBDS was visualized in 30% of patients. MRC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 85%, 90%, 77%, 94%, and 89%, respectively.


CONCLUSIONS
MRC is useful for the evaluation of patients with suspected choledocholithiasis. Advantages of MRC include its noninvasive nature, ease of application, and accuracy in identifying and estimating the size of CBDS. Application of MRC in this setting reduces the need for diagnostic endoscopic retrograde cholangiography. Future investigations should be directed at the development of cost-effective utilization strategies for MRC application.
Liu
T H
TH
Department of Surgery, The University of Texas, Houston Health Science Center at Lyndon B. Johnson General Hospital, 77026-1967, USA.
Consorti
E T
ET
Kawashima
A
A
Ernst
R D
RD
Black
C T
CT
Greger
P H
PH
Fischer
R P
RP
Mercer
D W
DW
D000328:Adult; D000465:Algorithms; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D042882:Gallstones / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012680:Sensitivity and Specificity