Role of Magnetic Resonance Cholangiopancreatography in Evaluation of Choledocholithiasis in Patients with Suspected Cholecystitis

ABSTRACT

PURPOSE@#To determine the role of magnetic resonance cholangiopancreatography (MRCP) in evaluation of choledocholithiasis in patients with suspected cholecystitis.@*MATERIALS AND METHODS@#A total of 78 patients (mean age: 66.06 ± 15.63 years; range: 21–94 years, Male:Female = 31:47) who had experienced symptoms of cholecystitis and who underwent computed tomography (CT), MRCP, and endoscopic retrograde cholangiopancreatography from January 2013 to February 2015 were included in this study. Two reviewers independently interpreted CT and MRCP images to determine the presence or absence of choledocholithiasis and cholelithiasis. Diagnostic performance (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) was compared between CT and MRCP. Interobserver agreement was also evaluated.@*RESULTS@#Forty-three patients underwent cholecystectomy. The accuracy of CT and MRCP for detection of gallbladder stones showed no significant difference. The sensitivity and accuracy of MRCP for detection of extrahepatic duct stones were superior to those of CT for both reviewers (reviewer 1: MRCP: sensitivity, 73.3%; accuracy, 76.9%; CT: sensitivity, 50%, accuracy 59%; p = 0.01; reviewer 2: MRCP: sensitivity, 75%; accuracy, 73.1%; CT: sensitivity, 50%; accuracy, 56.4%; p = 0.018). The interobserver agreement was consistent for both CT (k-value: 0.738) and MRCP (k-value: 0.701).@*CONCLUSION@#MRCP showed superior diagnostic performance for the detection of choledocholithiasis with reliable interobserver agreement. Considering the lack of radiation and contrast enhancement, MRCP would be an appropriate first-line modality in evaluation of common bile duct stones in patients with suspected cholecystitis.