Department of Radiology and Nuclear Medicine, The University of Jordan, Amman, Jordan.
School of Medicine, The University of Jordan, Amman, Jordan.
J Clin Ultrasound. 2022 Feb;50(2):247-253. doi: 10.1002/jcu.23136. Epub 2022 Jan 7.
The aim of this study is to compare the diagnostic accuracy of ultrasonography (US) with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of choledocholithiasis in context of laboratory blood test values.
This retrospective study included patients who underwent both MRCP and US as part of their choledocholithiasis workup. MRCP findings, reviewed by two board-certified radiologists, laboratory findings, and US reports were collected.
Our study included 243 patients. On US examination 74 cases were found dilated (30.5%), while 94 cases showed dilation (38.7%) by MRCP. The overall accuracy of US was 76.1%, where 185 patients had similar MRCP and US findings, 7.8% had false positive ultrasound, and 16% had false negative ultrasound finding. The accuracy of ultrasound was significantly higher in males (p = .013). In addition, a significant difference in duct dilatation as found by ultrasound and accuracy of diagnosis (p = .01).
Although US has a relatively low accuracy, its properties of being cost-effective and non-invasive make it an ideal first step in the diagnosis of choledocholithiasis. If a patient has elevated liver enzymes or a high risk of choledocholithiasis, we recommend that MRCP be performed even no dilation was seen on US.
本研究旨在比较超声（US）与磁共振胰胆管成像（MRCP）在实验室血液检查值背景下诊断胆总管结石的诊断准确性。
本回顾性研究纳入了同时接受 MRCP 和 US 检查以明确胆总管结石的患者。收集了 MRCP 检查结果（由两位经过董事会认证的放射科医生进行评估）、实验室检查结果和 US 报告。
我们的研究纳入了 243 例患者。US 检查发现 74 例存在胆管扩张（30.5%），MRCP 检查发现 94 例存在胆管扩张（38.7%）。US 的总体准确率为 76.1%，其中 185 例患者的 MRCP 和 US 检查结果相似，7.8%的患者超声检查结果为假阳性，16%的患者超声检查结果为假阴性。男性的超声准确率明显更高（p =.013）。此外，超声检查发现的胆管扩张程度与诊断准确率之间存在显著差异（p =.01）。
尽管 US 的准确率相对较低，但由于其具有经济实惠且非侵入性的特点，使其成为胆总管结石诊断的理想初始检查方法。如果患者的肝酶升高或存在胆总管结石的高风险，即使 US 未见胆管扩张，我们也建议进行 MRCP 检查。
