Document Detail


Diagnosing bile duct stones: comparison of unenhanced helical CT, oral contrast-enhanced CT cholangiography, and MR cholangiography.
MedLine Citation:
PMID:  11000177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In this investigation we compared the diagnostic performance of unenhanced helical CT, oral contrast-enhanced CT cholangiography, and MR cholangiography for the diagnosis of choledocholithiasis. SUBJECTS AND METHODS: Fifty-one patients referred for endoscopic retrograde cholangiography of suspected biliary stones were studied with unenhanced helical CT, MR cholangiography, and helical CT performed after oral administration of a cholangiographic contrast agent (iopodic acid). The studies were randomized for interpretation. Two radiologists evaluated the images by consensus and determined the presence and location of stones. We used retrograde cholangiography findings as the standard of reference. Sensitivity and specificity (with 95% confidence intervals [CIs]) of the three examinations were calculated and compared using the exact form of the McNemar test. RESULTS: Bile duct stones were revealed with retrograde cholangiography in 26 patients (51%). Sensitivity was 65% (95% CI, 44.4-82%) for unenhanced helical CT, 92% (95% CI, 73-99%) for CT cholangiography, and 96% (95% CI, 78-99%) for MR cholangiography. Specificity was 84% (95% CI, 63-95%) for unenhanced helical CT, 92% (95% CI, 73-99%) for CT cholangiography, and 100% (95% CI, 83-100%) for MR cholangiography. The sensitivity of CT cholangiography and MR cholangiography was significantly higher than that of unenhanced helical CT (p<0.01). Differences in specificity were not significant. CONCLUSION: Our results indicate that oral contrast-enhanced CT cholangiography and MR cholangiography are significantly more sensitive than unenhanced helical CT for the detection of bile duct calculi.
Authors:
J A Soto; O Alvarez; F M?nera; S M Velez; J Valencia; N Ram?rez
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  175     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-13     Completed Date:  2000-10-13     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1127-34     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Universidad de Antioquia, Hospital Universitario San Vicente de Pa?l, Calle 64 x Kra. 51D, Medell?n, Colombia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cholangiography*
Contrast Media*
Female
Gallstones / diagnosis*
Humans
Image Enhancement*
Image Processing, Computer-Assisted
Liver Function Tests
Magnetic Resonance Imaging*
Male
Middle Aged
Sensitivity and Specificity
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Contrast Media

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