VALUE OF 3-DIMENSIONAL GRADIENT-ECHO MAGNETIC-RESONANCE CHOLANGIOGRAPHY IN DIAGNOSING CHOLEDOCHOLITHIASIS

OBJECTIVE: TO evaluate the role of magnetic resonance cholangiography (MRC) in patients with suspected choledocholithiasis. PATIENTS AND MET HODS: Twenty-six consecutive patients with suspected choledocholithias is (11 men and 15 women ranging in age from 25 to 81 years) underwent three-dimensional gradient-echo MRC; each patient also underwent endos copic retrograde cholangiography or operative cholangiography. Each se t of images for each patient was reviewed independently by a radiologi st who was unaware of the results of the other type of imaging. RESULT S: Diagnostic-quality MRC images were obtained for 17 of the patients. Of these, 13 had stones in the common bile duct, as confirmed by anot her imaging method, and MRC indicated the presence of these stones in all 13 patients. In the other four patients bile duct obstruction was due to either acute pancreatitis (in three) or cholangiocarcinoma (in one). For seven of the nine nondiagnostic-quality MRC studies, the bil e duct was not obstructed, so there was no bile stasis and the MRC ima ges could not be obtained. Motion artifacts due to inability to hold t he breath were the limiting factors in the other two patients. CONCLUS ION: Although MRC has some limitations, this new noninvasive technique may be used as a screening test in selected patients with suspected c holedocholithiasis.