BACKGROUND:Magnetic resonance cholangiography (MRC)is a non-invasive method for imaging biliary ducts.When used to exclude common bile duct(CBD) stones,MRC may obviate the need for intra-operative cholangiography(IOC)...BACKGROUND:Magnetic resonance cholangiography (MRC)is a non-invasive method for imaging biliary ducts.When used to exclude common bile duct(CBD) stones,MRC may obviate the need for intra-operative cholangiography(IOC).In this prospective study,MRC and IOC were compared for the diagnosis of suspected stones of the CBD. METHODS:Thirty patients with gallstones and suspected CBD lithiasis(abnormal serum liver tests and CBD>7 mm on ultrasound)had MRC followed by open cholecystectomy and IOC.MR imaging was done using a 1.5-T whole body scanner(Signa,General Electric Medical Systems).A torso phased-array coil with a 4-channel receiver was used for data acquisition. RESULTS:Over a period of 18 months,30 patients(average age 53.9±13.3 years;range 38-76 years)were enrolled in this study.Eleven patients were male(36.7%)and 19 female(63.3%).MRC revealed CBD stones in 19 patients, while IOC revealed CBD stones in 22.The sensitivity of MRC in detecting CBD stones was 81.8%,and the specificity was 87.5%.The positive predictive value was 94.7%,and the negative predictive value was 63.3%. CONCLUSIONS:Pre-operative MRC may obviate the need for IOC.MRC reduces operative time,is less invasive, and may also alleviate damage to the CBD that can occurduring IOC.MRC can identify CBD stones pre-operatively and can help surgeons plan safe procedures.Pre-operative MRC should be done routinely in patients whose clinical or biochemical findings suggest the possibility of CBD stones.展开更多
文摘BACKGROUND:Magnetic resonance cholangiography (MRC)is a non-invasive method for imaging biliary ducts.When used to exclude common bile duct(CBD) stones,MRC may obviate the need for intra-operative cholangiography(IOC).In this prospective study,MRC and IOC were compared for the diagnosis of suspected stones of the CBD. METHODS:Thirty patients with gallstones and suspected CBD lithiasis(abnormal serum liver tests and CBD>7 mm on ultrasound)had MRC followed by open cholecystectomy and IOC.MR imaging was done using a 1.5-T whole body scanner(Signa,General Electric Medical Systems).A torso phased-array coil with a 4-channel receiver was used for data acquisition. RESULTS:Over a period of 18 months,30 patients(average age 53.9±13.3 years;range 38-76 years)were enrolled in this study.Eleven patients were male(36.7%)and 19 female(63.3%).MRC revealed CBD stones in 19 patients, while IOC revealed CBD stones in 22.The sensitivity of MRC in detecting CBD stones was 81.8%,and the specificity was 87.5%.The positive predictive value was 94.7%,and the negative predictive value was 63.3%. CONCLUSIONS:Pre-operative MRC may obviate the need for IOC.MRC reduces operative time,is less invasive, and may also alleviate damage to the CBD that can occurduring IOC.MRC can identify CBD stones pre-operatively and can help surgeons plan safe procedures.Pre-operative MRC should be done routinely in patients whose clinical or biochemical findings suggest the possibility of CBD stones.
