CHOLEDOCHOLITHIASIS - EVALUATION OF MR CHOLANGIOGRAPHY FOR DIAGNOSIS

PURPOSE: To evaluate the test performance of magnetic resonance (MR) c holangiography for help in diagnosing choledocholithiasis. MATERIALS A ND METHODS: Fast spin-echo MR cholangiography was performed by using a torso multicoil array in 110 patients suspected of having bile duct o bstruction. Axial and coronal images were reviewed by two observers wh o were blinded to results of direct cholangiography and final diagnose s. The final diagnosis Was established; by using direct cholangiograph ic (n = 103) or surgical (n = 7) findings. RESULTS: Of the 110 patient s, 30 (27%) had choledocholithiasis, and 80 (73%) did not. Reviewer 1 used MR cholangiograms to achieve a sensitivity of 90%, specificity of 100%, positive predictive value of 100%, negative predictive value of 96%, and overall accuracy of 97%,Reviewer 2 achieved a sensitivity of 90%, specificity of 93%, positive predictive value of 82%, negative p redictive value of 96%, and overall accuracy of 92%. Interobserver agr eement for MR cholangiograms was 93% (kappa = 0.82). CONCLUSION: MR ch olangiography exhibited excellent test performance and resulted excell ent interobserver agreement for the diagnosis of choledocholithiasis.