Park M S, Yu J S, Kim Y H, Kim M J, Kim J H, Lee S, Cho N, Kim D G, Kim K W
Department of Diagnostic Radiology, Yonsei University College of Medicine, YongDong Severance Hospital, Seoul, South Korea.
Radiology. 1998 Dec;209(3):781-5. doi: 10.1148/radiology.209.3.9844674.
To evaluate the clinical usefulness of magnetic resonance (MR) cholangiography in the assessment of acute cholecystitis by comparing the diagnostic accuracy of MR cholangiography with that of ultrasonography (US).
Thirty-five patients with symptoms of acute cholecystitis underwent both US and MR cholangiography before cholecystectomy, which helped confirm acute cholecystitis. Two reviewers evaluated US and MR cholangiographic images for evidence of calculi and gallbladder wall thickening and compared these findings with surgical findings.
MR cholangiography depicted all 21 (100%) calculi and one false-positive calculus in the cystic duct and gallbladder neck, but US depicted only one (14%) of seven cystic duct calculi and 12 (86%) of 14 gallbladder neck calculi. In the diagnosis of cystic duct obstruction, MR cholangiography had a sensitivity of 100%, a specificity of 93%, and an accuracy of 97%. US had a sensitivity of 62%, a specificity of 100%, and an accuracy of 77%. In the diagnosis of gallbladder wall thickening, MR cholangiography had a sensitivity of 69%, a specificity of 83%, and an accuracy of 71%. US had a sensitivity of 96%, a specificity of 83%, and an accuracy of 94%.
In the assessment of acute cholecystitis, US is superior to MR cholangiography in the evaluation of gallbladder wall thickening. However, MR cholangiography is superior to US in the depiction of cystic duct and gallbladder neck calculi at the evaluation of cystic duct obstruction.
通过比较磁共振胆管造影（MR cholangiography）与超声检查（US）的诊断准确性，评估MR cholangiography在急性胆囊炎评估中的临床实用性。
35例有急性胆囊炎症状的患者在胆囊切除术前接受了US和MR cholangiography检查，这有助于确诊急性胆囊炎。两名阅片者评估US和MR cholangiography图像以寻找结石和胆囊壁增厚的证据，并将这些发现与手术结果进行比较。
MR cholangiography显示了所有21枚（100%）结石以及胆囊管和胆囊颈部的1枚假阳性结石，但US仅显示了7枚胆囊管结石中的1枚（14%）和14枚胆囊颈部结石中的12枚（86%）。在胆囊管梗阻的诊断中，MR cholangiography的敏感性为100%，特异性为93%，准确性为97%。US的敏感性为62%，特异性为100%，准确性为77%。在胆囊壁增厚的诊断中，MR cholangiography的敏感性为69%，特异性为83%，准确性为71%。US的敏感性为96%，特异性为83%，准确性为94%。
在急性胆囊炎的评估中，US在评估胆囊壁增厚方面优于MR cholangiography。然而，在评估胆囊管梗阻时，MR cholangiography在显示胆囊管和胆囊颈部结石方面优于US。
