Reinhold C, Taourel P, Bret P M, Cortas G A, Mehta S N, Barkun A N, Wang L, Tafazoli F
Department of Diagnostic Radiology, Montreal General Hospital, Quebec, Canada.
Radiology. 1998 Nov;209(2):435-42. doi: 10.1148/radiology.209.2.9807570.
To evaluate the test performance of magnetic resonance (MR) cholangiography for help in diagnosing choledocholithiasis.
Fast spin-echo MR cholangiography was performed by using a torso multicoil array in 110 patients suspected of having bile duct obstruction. Axial and coronal images were reviewed by two observers who were blinded to results of direct cholangiography and final diagnoses. The final diagnosis was established by using direct cholangiographic (n = 103) or surgical (n = 7) findings.
Of the 110 patients, 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 predictive value of 96%, and overall accuracy of 92%. Interobserver agreement for MR cholangiograms was 93% (kappa = 0.82).
MR cholangiography exhibited excellent test performance and resulted in excellent interobserver agreement for the diagnosis of choledocholithiasis.
评估磁共振（MR）胆管造影术在诊断胆总管结石方面的检测性能。
采用体部多线圈阵列对110例疑似胆管梗阻患者进行快速自旋回波MR胆管造影。由两名对直接胆管造影结果和最终诊断不知情的观察者对轴位和冠状位图像进行评估。最终诊断通过直接胆管造影（n = 103）或手术（n = 7）结果确定。
110例患者中，30例（27%）患有胆总管结石，80例（73%）未患。观察者1利用MR胆管造影获得的敏感度为90%，特异度为100%，阳性预测值为100%，阴性预测值为96%，总体准确率为97%。观察者2的敏感度为90%，特异度为93%，阳性预测值为82%，阴性预测值为96%，总体准确率为92%。MR胆管造影的观察者间一致性为93%（kappa = 0.82）。
MR胆管造影术在诊断胆总管结石方面表现出优异的检测性能，观察者间一致性良好。
