MAGNETIC-RESONANCE CHOLANGIOGRAPHY USING HALF-FOURIER ACQUISITION FORDIAGNOSING CHOLEDOCHOLITHIASIS

Objective: Magnetic resonance cholangiography (MRC), using a half-Four ier acquisition single-shot turbo spin-echo (HASTE) sequence, noninvas ively provides very rapid (1-2 s) and high-quality images of the bilia ry tract. We assessed the diagnostic usefulness of HASTE-MRC for chole docholithiasis. Methods: A total of 101 patients with suspected choled ocholithiasis underwent MRC, ultrasonography, and endoscopic retrograd e cholangiopancreatography (ERCP), In 97 patients in whom ERCP fully d epicted the common bile duct, we retrospectively analyzed the capabili ty of MRC to image the common bile duct and to diagnose choledocholith iasis, in comparison with that of ultrasonography. Results: In 34 pati ents, ERCP demonstrated bile duct stones, which were confirmed at endo scopic or surgical treatment. The common bile duct was fully delineate d in 98% by MRC and in 70% by ultrasonography. MRC (91%) was more sens itive than ultrasonography (71%) for detecting choledocholithiasis (p < 0.05). MRC demonstrated bile duct stones in all patients with stones greater than or equal to 11 mm but missed calculi in the 29% of patie nts with small (3-5 mm) stones. MRC was capable of detecting choledoch olithiasis regardless of bile duct caliber, The specificity of MRC (10 0%) was higher than that of ultrasonography (95%). Conclusion: HASTE-M RC, a fast and noninvasive procedure, can accurately diagnose choledoc holithiasis although the detectability for small stones is limited. (A m J Gastroenterol 1998;93: 1886-1890. (C) 1998 by Am. Cell. of Gastroe nterology)