MAGNETIC-RESONANCE-IMAGING IN EVALUATION OF THE COMMON BILE-DUCT

Background The ideal method for evaluation of the common bile duct (CB D) before or during cholecystectomy remains controversial. Magnetic re sonance cholangiography (MRC) is a new, promising technique. A prospec tive evaluation is reported. Method Sixty-one patients (45 women) were studied by MRC. There were 29 patients with symptomatic gallstone dis ease and without clinical, biochemical or ultrasonographic evidence of CBD stones (group 1); 28 of them also underwent intraoperative cholan giography (IOC), In addition, there were 21 patients with symptomatic gallstone disease, with mild biochemical and ultrasonographic signs of CBD involvement (group 2), of whom 19 underwent IOC, and Il patients with symptomatic CBD stones (group 3) nine of whom had preoperative en doscopic retrograde cholangiopanereatography (ERCP) following MRC. Res ults MRC showed that no patient in group I and three patients in group 2 had CBD stones. Three patients (one in group II two in group 2) did not undergo IOC because of technical or clinical problems. In group 3 , ERCP confirmed the results of MRC in nine patients, Two patients und erwent open surgery because of ultrasonographic, MRC and radiographic signs of pancreatic malignancy. Conclusion MRC could replace IOC and E RCP for identification of asymptomatic CBD stones. In symptomatic pati ents MRC combined with other non-invasive imaging techniques can direc t the surgeon to appropriate management.