Combination of magnetic resonance cholangiopancreatography and computed tomography for preoperative diagnosis of the Mirizzi syndrome.
OBJECTIVE
To determine the diagnostic accuracy of combined magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) for preoperative diagnosis of Mirizzi syndrome.


METHODS
Fifty-two patients with surgically proven Mirizzi syndrome (n = 13) and cholecystitis without evidence for Mirizzi syndrome (n = 39) underwent both MRCP using single-shot turbo spin echo and 3-dimensional turbo spin echo sequences and CT. Two blinded observers independently and retrospectively reviewed the combination of MRCP and CT images and CT images alone. Diagnostic accuracy for a combined protocol and CT was evaluated.


RESULTS
The overall sensitivity, specificity, positive and negative predictive values, and accuracy of the combination of MRCP and CT were 96.0%, 93.5%, 83.5%, 98.5%, and 94.0%, respectively. Corresponding values of CT were 42.0%, 98.5%, 93.0%, 83.5%, and 85.0%, respectively. The sensitivity, negative predictive value, and accuracy of combined protocol were significantly higher than those of CT alone (P = 0.000, 0.001, and 0.042, respectively). Interobserver agreement was better for combined images (kappa = 0.906) than for CT images alone (kappa = 0.812).


CONCLUSIONS
A combination of MRCP and CT is useful for preoperative diagnosis of Mirizzi syndrome.
Yun
Eun Joo
EJ
Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea. yeunjookr@yahoo.co.kr
Choi
Chul Soon
CS
Yoon
Dae Young
DY
Seo
Young Lan
YL
Chang
Suk Ki
SK
Kim
Joo Seop
JS
Woo
Ji Young
JY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000473:pathology; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D002763:Cholecystectomy; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002765:Cholecystography / Q000379:methods; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005704:Gallbladder / Q000473:pathology / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D011300:Preoperative Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013577:Syndrome; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult