Document Detail


Detection of choledocholithiasis: comparison of unenhanced spiral CT, US, and ERCP.
MedLine Citation:
PMID:  11148990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: ERCP is an established method for the diagnosis and treatment of common bile duct stones, however, it is invasive, time-consuming, and expensive. The purpose of this study was to determine whether unenhanced spiral CT and US, compared with ERCP, have sufficient sensitivity and negative predictive value to be useful screening techniques in patients suspected of having choledocholithiasis. METHODOLOGY: Over a period of 2 years, 82 patients with clinically suspected choledocholithiasis underwent unenhanced spiral computed tomography and US immediately before undergoing endoscopic retrograde cholangiopancreatography. CT/US scans and ERCP images were evaluated for the presence of bile duct stones, ampullary stones, and extrahepatic biliary dilatation. RESULTS: Unenhanced spiral computed tomography (US) depicted common bile duct stones in 24 (23) of 28 patients found to have stones at endoscopic retrograde cholangiopancreatography. Five patients had stones impacted at the ampulla, all (two) of which were detected with CT (US). Computed tomography (US) had a sensitivity of 86% (82%) and a specificity of 98% (98%) in the diagnosis of choledocholithiasis. CONCLUSIONS: Both unenhanced spiral CT and US are useful for evaluating suspected common bile duct stones. Unenhanced spiral CT is especially useful when the patient is likely to have ampullary stones and is a safe, more available and less expensive alternative to magnetic resonance cholangiography.
Authors:
D Pickuth; R P Spielmann
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  47     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2000 Nov-Dec
Date Detail:
Created Date:  2001-01-08     Completed Date:  2001-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1514-7     Citation Subset:  IM    
Affiliation:
Department of Abdominal Radiology, Martin-Luther-University, Faculty of Medicine, Magdeburger Strasse 16, D-06112 Halle/Saale, Germany. pickuth@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
Female
Gallstones / diagnosis*,  radiography,  ultrasonography
Humans
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Tomography, X-Ray Computed

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