Document Detail


Can computed tomography with coronal reconstruction improve the diagnosis of choledocholithiasis?
MedLine Citation:
PMID:  18713297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Many technical developments of computed tomography (CT) made in recent years have improved imaging quality. However, the diagnostic efficacy of CT with coronal reconstruction for choledocholithiasis remains uncertain. This study aimed to investigate if CT with coronal reconstruction can aid in the diagnosis of choledocholithiasis. METHODS: Two hundred and sixty-six patients with clinically suspected choledocholithiasis undergoing abdominal CT before endoscopic retrograde cholangiopancreatography were recruited. Among them, 163 patients confirmed with choledocholithiasis were divided into three groups: group 1, 92 patients undergoing CT using 5-mm thick sections with coronal reconstruction; group 2, 32 patients undergoing CT using 5-mm thick sections without coronal reconstruction; and group 3, 39 patients undergoing CT using 7-mm thick sections without coronal reconstruction. The diagnostic rate of CT for choledocholithiasis, the stone size and biochemical data among the three groups were analyzed. RESULTS: The sensitivity and specificity of CT in diagnosing choledocholithiasis were 77.3% and 72.8%. There was no significant difference of CT diagnostic rate among the three groups (75.0%, 81.2% and 79.5%, respectively). The diameter of common bile duct (CBD), size of CBD stones and white cell count showed significant differences between CT true-positive and false-negative cases in group 1 patients. The CT diagnostic rate was significantly lower in patients with choledocholithiasis of less than 5 mm than in patients with choledocholithiasis of 5 mm or more (56.5% vs 81.2%). CONCLUSION: The coronal reconstruction of CT imaging did not increase its diagnostic efficacy on choledocholithiasis. The stone size affects the diagnostic rate of abdominal CT for detecting choledocholithiasis.
Authors:
Chih-Wei Tseng; Chun-Chia Chen; Tseng-Shing Chen; Full-Young Chang; Han-Chieh Lin; Shou-Dong Lee
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2008-08-17
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  23     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-04-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1586-9     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
Choledocholithiasis / radiography*
Common Bile Duct / radiography*
Female
Gallstones / radiography*
Humans
Male
Middle Aged
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed*

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