Role of Multidetector Computerized Tomography (MDCT) in Identification of Common Bile Duct Stone: Comparison with ERCP / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: MDCT, which provides high resolution and various reconstructing images, has recently become widely available and is a promising tool for imaging the bile duct with precision. In order to evaluate the diagnostic value of multidetector computerized tomography (MDCT) for a common bile duct (CBD) stone, this study compared the diagnostic accuracy of MDCT with that of ERCP. METHODS: The medical records of the patients undergoing both MDCT and ERCP consecutively from June 2006 to January 2007 were retrospectively reviewed. One hundred and sixty four patients (164 cases) were enrolled in this study. The final diagnoses were based mainly on the ERCP findings. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of MDCT and ERCP for choledocholithiasis were identified and compared. RESULTS: Of the 164 cases, 47 cases were diagnosed with choledocholithiasis. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for choledocholithiasis were 89.4%, 98.3%, 95.5%, 95.8%, 95.7% in MDCT and 97.9%, 99.1%, 97.9%, 99.1%, 98.8% in ERCP, respectively. There were no statistically significant differences in the diagnostic accuracy between the two methods (p=0.206). CONCLUSIONS: MDCT has high sensitivity and specificity for diagnosing stones in the bile duct and should be performed in preference to ERCP in patients suspected of having choledocholithiasis.