Improved diagnosis of common bile duct stone with single-shot balanced turbo field-echo sequence in MRCP

Abdom Radiol (NY). 2017 Apr;42(4):1183-1188. doi: 10.1007/s00261-016-0990-6.

Abstract

Purpose: To evaluate the value of adding single-shot balanced turbo field-echo (b-TFE) sequence to conventional magnetic resonance cholangiopancreatography (MRCP) for the detection of common bile duct (CBD) stone.

Methods: One hundred thirty-seven consecutive patients with suspected CBD stone underwent MRCP including single-shot b-TFE sequence. Twenty-five patients were confirmed with CBD stone by endoscopic retrograde cholangiopancreatography or ultrasonography. Two radiologists reviewed two image protocols: protocol A (conventional MRCP protocol: unenhanced T1-, T2-, and respiratory-triggered three-dimensional fat-suppressed single-shot turbo spin-echo MRCP sequence) and protocol B (protocol A plus single-shot b-TFE sequence). The sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and area under the receiver-operating-characteristic (ROC) curve (AUC) for the detection of CBD stone were compared.

Results: The sensitivity (72%) and NPV (94%) were the same between the two protocols. However, protocol B was greater in the specificity (99%) and PPV (94%) than protocol A (92% and 67%, respectively) (P = 0.0078 and 0.031, respectively). The AUC was significantly greater for protocol B (0.93) than for protocol A (0.86) (P = 0.026).

Conclusions: Inclusion of single-shot b-TFE sequence to conventional MRCP significantly improved the specificity and PPV for the detection of CBD stone.

Keywords: Common bile duct stone; MRCP; Positive predictive value; Single-shot balanced turbo field-echo sequence; Specificity.

MeSH terms

  • Adult
  • Aged
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholangiopancreatography, Magnetic Resonance* / methods
  • Common Bile Duct / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Gallstones / diagnostic imaging*
  • Humans
  • Image Enhancement / methods*
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Ultrasonography