Role of Magnetic Resonance Cholangiography (MRC) in Patients with suspected Choledocholithiasis

Abstract

Objective: To evaluate the diagnostic accuracy of magnetic resonance cholangiography (MRC) in patients with suspected choledocholithiasis.

Study Design: Cross sectional / comparative diagnostic procedural study

Place and Duration of Study: This study was conducted at the Department of Radiology & Gastroenterology Nishtar Medical College & Hospital, Multan from March 2011 to March 2012

Materials and Methods: 50 patients (25 men and 25 women) having mean age of 50 years with suspected choledocholithiasis on sonography were included in the study.MR cholangiogram with two dimensional turbo spin echo sequences were acquired.ER cholangiogram was performed as a reference imaging technique.

Results:  48 out of 50 patients had bile duct stone on reference imaging technique. Two patients were truly negative for choledocholithiasis.MR cholangiogram was positive in 45 patients.MR cholangiogram missed CBD calculi in three patients that were positive on ER cholangiogram having size of calculi <6mm.33.3% patients had single calculus, while 66.7% have multiple CBD calculi. Stone size was 6mm in 25(55.5%) patients,6-10mm in 15(33.3%) patients and >10mm in 5(11.2%) patients

Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV),and accuracy  of MR cholangiogram were 93.7%,100%,100%,40% and 94% respectively

Conclusion: MR Cholangiogram provides results comparable with the ER cholangiogram in patients with suspected bile duct obstruction due to choledocholithiasis. In patients in whom an interventional endoscopic procedure is unlikely, MR Cholangiogram can replace ER Cholangiogram as a diagnostic tool, as it is non invasive and well tolerated by patients