Short- Versus Long-sequence MRI Cholangiography for the Preoperative Imaging of the Common Bile Duct in Patients with Cholecystolithiasis

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2005 Jul 16

PMID 16021379

Citations 4

Authors

A Shamiyeh

E Lindner

J Danis

K Schwarzenlander

W Wayand

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to compare an 18-s fast spin echo magnetic resonance image sequence (coronal thick-section two-dimensional breathhold) with a three-dimensional axial and coronal thin-section sequence and its secondary reconstruction, and to assess its value in the diagnosis of bile duct pathologies, particularly common bile duct stones (CBDS) before laparoscopic cholecystectomy.

Methods: This study prospectively included 72 patients. Because of protocol violations, 14 of these patients had to be excluded. Thus, 58 patients (29 Man and 29 women with a mean age of 51 years) who had cholecystolithiasis or suspected choledocholithiasis were evaluated. Magnetic resonance cholangiopancreatography (MRCP) was performed for all patients with a fast sequence (18 s) and a long sequence (coronal oblique and axial respiratory triggered; 16 min). Two radiologists, blinded with respect to diagnosis, evaluated all the radiographic images. The MRCP results were confirmed for all the patients: 20 by endoscopic retrograde cholangiopancreatography, 46 by intraoperative cholangiography, and 2 by percutaneous transhepatic cholangiography.

Results: According to the findings, 16 patients (28%) had CBDS, 6 patients (10%) had common bile duct stenosis, and 36 patients (62%) had a clear bile duct. With regard to CBDS, the short sequence had 100% specificity, 94% sensitivity, and an overall accuracy of 98%. Its negative predictive value was 98%, and its positive predictive value was 100%. The long sequence had a specificity of 100% and a sensitivity of 100%.

Conclusion: Because of its high sensitivity and specifity, MRCP has the potential to be the diagnostic method of choice for CBD evaluation. The short sequence is not suitable for the diagnosis of all CBD pathologies, but in cases of suspected CBDS, more than 80% of the patients could be diagnosed correctly, and the complete sequence could be dropped.

Citing Articles

Diagnostic value of T-tube cholangiography and choledochoscopy in residual calculi after biliary surgery.

Li S, Wang Z, Li Z, Wang K, Sui M, Liu D BMC Gastroenterol. 2024; 24(1):383.

PMID: 39468442 PMC: 11514883. DOI: 10.1186/s12876-024-03474-7.

Diagnostic value of magnetic resonance cholangiopancreatography in choledocholithiasis.

Chen W, Mo J, Lin L, Li C, Zhang J World J Gastroenterol. 2015; 21(11):3351-60.

PMID: 25805944 PMC: 4363767. DOI: 10.3748/wjg.v21.i11.3351.

Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones.

Giljaca V, Gurusamy K, Takwoingi Y, Higgie D, Poropat G, Stimac D Cochrane Database Syst Rev. 2015; (2):CD011549.

PMID: 25719224 PMC: 6464848. DOI: 10.1002/14651858.CD011549.

Management of common bile duct stones.

Hungness E, Soper N J Gastrointest Surg. 2006; 10(4):612-9.

PMID: 16627230 DOI: 10.1016/j.gassur.2005.08.015.

References

Arguedas M, DuPont A, Wilcox C . Where do ERCP, endoscopic ultrasound, magnetic resonance cholangiopancreatography, and intraoperative cholangiography fit in the management of acute biliary pancreatitis? A decision analysis model. Am J Gastroenterol. 2001; 96(10):2892-9. DOI: 10.1111/j.1572-0241.2001.04244.x. View

Menon K, Barkun A, Romagnuolo J, Friedman G, Mehta S, Reinhold C . Patient satisfaction after MRCP and ERCP. Am J Gastroenterol. 2001; 96(9):2646-50. DOI: 10.1111/j.1572-0241.2001.04117.x. View

Cova M, Stacul F, Cester G, Ukmar M, Mucelli R . [MR cholangiopancreatography: comparison of 2D single-shot fast spin-echo and 3D fast spin-echo sequences]. Radiol Med. 2003; 106(3):178-90. View

Soto J, Barish M, Yucel E, Ferrucci J . MR cholangiopancreatography: findings on 3D fast spin-echo imaging. AJR Am J Roentgenol. 1995; 165(6):1397-401. DOI: 10.2214/ajr.165.6.7484573. View

Demartines N, Eisner L, Schnabel K, Fried R, Zuber M, Harder F . Evaluation of magnetic resonance cholangiography in the management of bile duct stones. Arch Surg. 2000; 135(2):148-52. DOI: 10.1001/archsurg.135.2.148. View

Rosch T, Meining A, Fruhmorgen S, Zillinger C, Schusdziarra V, Hellerhoff K . A prospective comparison of the diagnostic accuracy of ERCP, MRCP, CT, and EUS in biliary strictures. Gastrointest Endosc. 2002; 55(7):870-6. DOI: 10.1067/mge.2002.124206. View

Deviere J, Matos C, Cremer M . The impact of magnetic resonance cholangiopancreatography on ERCP. Gastrointest Endosc. 1999; 50(1):136-40; discussion 140-3. DOI: 10.1016/s0016-5107(99)70367-6. View

Park A, Mastrangelo Jr M . Endoscopic retrograde cholangiopancreatography in the management of choledocholithiasis. Surg Endosc. 2000; 14(3):219-26. DOI: 10.1007/pl00021297. View

Collins C, Maguire D, Ireland A, Fitzgerald E, OSullivan G . A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy: natural history of choledocholithiasis revisited. Ann Surg. 2003; 239(1):28-33. PMC: 1356189. DOI: 10.1097/01.sla.0000103069.00170.9c. View

10.

Ernst O, Asselah T, El Fakir Y, Mizrahi D, Carpentier F, LHERMINE C . [MR cholangiopancreatography]. Ann Chir. 1997; 51(10):1111-4. View

11.

Scheiman J, Carlos R, Barnett J, Elta G, Nostrant T, Chey W . Can endoscopic ultrasound or magnetic resonance cholangiopancreatography replace ERCP in patients with suspected biliary disease? A prospective trial and cost analysis. Am J Gastroenterol. 2001; 96(10):2900-4. DOI: 10.1111/j.1572-0241.2001.04245.x. View

12.

Cuschieri A, Lezoche E, Morino M, Croce E, Lacy A, Toouli J . E.A.E.S. multicenter prospective randomized trial comparing two-stage vs single-stage management of patients with gallstone disease and ductal calculi. Surg Endosc. 1999; 13(10):952-7. DOI: 10.1007/s004649901145. View

13.

Sungler P, Holzinger J, Heinerman P, Waclawiczek H, BOECKL O . [Preoperative therapeutic splitting]. Zentralbl Chir. 1997; 122(12):1083-7. View

14.

Macaulay S, Schulte S, Sekijima J, Obregon R, SIMON H, Rohrmann Jr C . Evaluation of a non-breath-hold MR cholangiography technique. Radiology. 1995; 196(1):227-32. DOI: 10.1148/radiology.196.1.7784572. View

15.

Rieger R, Wayand W . Yield of prospective, noninvasive evaluation of the common bile duct combined with selective ERCP/sphincterotomy in 1390 consecutive laparoscopic cholecystectomy patients. Gastrointest Endosc. 1995; 42(1):6-12. DOI: 10.1016/s0016-5107(95)70235-0. View

16.

Zidi S, Prat F, Le Guen O, RONDEAU Y, Rocher L, Fritsch J . Use of magnetic resonance cholangiography in the diagnosis of choledocholithiasis: prospective comparison with a reference imaging method. Gut. 1998; 44(1):118-22. PMC: 1760072. DOI: 10.1136/gut.44.1.118. View

17.

Sharma S, Larson K, Adler Z, Goldfarb M . Role of endoscopic retrograde cholangiopancreatography in the management of suspected choledocholithiasis. Surg Endosc. 2003; 17(6):868-71. DOI: 10.1007/s00464-002-8704-2. View

18.

Sarli L, Pietra N, Franze A, COLLA G, Costi R, Gobbi S . Routine intravenous cholangiography, selective ERCP, and endoscopic treatment of bile duct stones before laparoscopic cholecystectomy. Gastrointest Endosc. 1999; 50(2):200-8. DOI: 10.1016/s0016-5107(99)70225-7. View

19.

Kim J, Kim M, Park S, Chung J, Song S, Kim K . MR cholangiography in symptomatic gallstones: diagnostic accuracy according to clinical risk group. Radiology. 2002; 224(2):410-6. DOI: 10.1148/radiol.2241011223. View

20.

Fernandez M, Csendes A, Yarmuch J, Diaz H, Silva J . Management of common bile duct stones: the state of the art in 2000. Int Surg. 2003; 88(3):159-63. View