title: Combination of magnetic resonance cholangiopancreatography and computed tomography for preoperative diagnosis of the Mirizzi syndrome.
abstract: 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.
authors.affiliation: Department of Radiology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea. yeunjookr@yahoo.co.kr
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Yun
authors.forename: Chul Soon
authors.initials: CS
authors.lastname: Choi
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Yoon
authors.forename: Young Lan
authors.initials: YL
authors.lastname: Seo
authors.forename: Suk Ki
authors.initials: SK
authors.lastname: Chang
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Kim
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Woo
mesh_terms: 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