Diagnosis of intrahepatic stones: superiority of MR cholangiopancreatography over endoscopic retrograde cholangiopancreatography.
OBJECTIVE
The purpose of this study was to compare the efficacy of MR cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis of intrahepatic stones.


METHODS
Of the 318 patients who underwent MRCP examinations at our institution during an 18-month period, we identified 49 patients who subsequently underwent surgery or cholangioscopic stone removal with proof of intrahepatic stones. Thirty-four of these patients also underwent ERCP; they made up our study population. All images were interpreted for the presence of bile duct stones: MRCP images were interpreted independently by two reviewers, and ERCP studies were interpreted by one reviewer who was unaware of the MRCP findings.


RESULTS
The sensitivity and specificity of MRCP for detecting intrahepatic stones were 97% and 93%, respectively, whereas those of ERCP were 59% and 97%, respectively. MRCP showed a significantly higher sensitivity than ERCP in the diagnosis of intrahepatic stones (p < 0.001). We found no significant difference between MRCP and ERCP in sensitivity or specificity for detecting calculi in the common duct or gallbladder.


CONCLUSIONS
MRCP is a more effective diagnostic method than ERCP for the evaluation of intrahepatic stones.
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnab-dong, Songpa-ku, Seoul 138-736, Korea.
Tae Kyoung
TK
Kim
Bong Soo
BS
Kim
Jung Hoon
JH
Kim
Hyun Kwon
HK
Ha
Pyo Nyun
PN
Kim
Ah Young
AY
Kim
Moon-Gyu
MG
Lee
D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000175:diagnosis; D001652:Bile Ducts / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002769:Cholelithiasis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D012680:Sensitivity and Specificity