MR CHOLANGIOGRAPHY (MRC) IN THE EVALUATION OF CBD STONES BEFORE LAPAROSCOPIC CHOLECYSTECTOMY

Background: The aim of our work was to evaluate the predictive value o f MR cholangiography (MRC) in detecting CBD stones before laparoscopic surgical treatment. Methods: MRC was performed as a unique preoperati ve imaging modality in 45 selected patients (16 male; 29 female; age r ange: 28-72; mean age: 54.4) before laparoscopic cholecystectomy. MRC imaging was obtained with a 3D Turbo Spin-Echo sequence(TR = 3000 ms, TE = 700 ms, Echo Train Length-128) with an acquisition time of 5 min 48 s. Diagnostic confirmation was obtained in all the cases at i.o. ch olangiography. When a stone was detected it was removed by transcystic or transcholedochal approach. Results: Eighteen of the 45 patients (4 0%) had CBD stones. MRC correctly evaluated 16 out of Is stones, with a resulting sensitivity of 88.9%, specificity 100%, positive predictiv e value 100%, negative predictive value 90%, and accuracy 95.6%. Concl usions: Despite the good results of MRC, it cannot be proposed as a sc reening technique to be performed in all patients submitted to laparos copic cholecystectomy due to high cost and the limited amount of MR eq uipment. In conclusion, only selected patients should be submitted to MRC before laparoscopic cholecystectomy.