Murat DANACI, AHMET VEYSEL POLAT, Ayfer KAMALI, Ümit BELET, Lütfi İNCESU, Necati ÖZEN, Mustafa Bekir SELÇUK

Koledok taşlarının tanısında manyetik rezonans kolanjiografi ve ultrasonografi

Koledok taşlarının tanısında ultrasonografl ve manyetik rezonans kolanjiografinin tanı değerini araştırmak. Tıkanma sarılığı bulguları ve koledok taşı şüphesi olan 42 hastada ultrasonografl ve manyetik rezonans kolanjiografi incelemesi yapıldı. Sonuçlar taş ve diğer patolojiler olarak iki gruba ayrıldı. Tüm hastaların sonuçları cerrahi olarak doğrulandı. Manyetik rezonans kolanjigrafide 18 hastada koledokta taş ile uyumlu görünüm izlendi. Bu hastalardan 17'sinde cerrahi olarak taş saptandı. Ultrasonografide ise 10 hastada taş 'gösterildi. Manyetik rezonans kolanjiografinin koledok taşlarının tanısında %100 duyarlılık, %96 özgüllük, ultrasonografinin ise %58.8 duyarlılık, %100 özgüllük oranları olduğu belirlendi. Koledok taşları tanısında manyetik rezonans kolanjiografi ultrasonografiye üstündür. Ultrasonografi safra yolu hastalıklarında ilk inceleme yöntemidir. Ancak ultrasonografl bulguları yetersiz ise manyetik rezonans kolanjiografi koledok taşlarının tanısında invaziv olmayan, güvenilir bir yöntem olarak kullanılabilir.

Anahtar Kelimeler:

Koledokolitiyaz, Ultrasonografi, Manyetik rezonans görüntüleme, Safra taşları, Duyarlılık ve özgüllük, Tanı

Magnetic resonance cholangiography and ultrasonography in the diagnosis of choledocholithiasis

The aim of this study is to investigate the diagnostic value of ultrasonography and magnetic resonance cholangiography in chledocholithiasis. Ultrasonography and magnetic resonance cholangiography were performed in 42 patients with findings of obstructice jaundice and suspicion of Choledocholithiasis. Results were classified as Choledocholithiasis and others. All the results were confirmed by surgery. Findings compatible with Choledocholithiasis was detected by magnetic resonance cholangiography in 18 patients. Choledocholithiasis was proven in 17 patients by surgery. However, Choledocholithiasis was shown by ultrasonography in 10 patients, all confirmed by surgery. Magnetic resonance cholangiography has 100% sensitivity, 96% specificity and ultrasonography has 58.8% sensitivity, 100% pecificity in the diagnosis of Choledocholithiasis. Magnetic resonance cholangiography is superior to ultrasonography in the diagnosis of Choledocholithiasis. Ultrasonography is the primary imaging modality in biliary system diseases. When ultrasonographic findings are unremarkable, magnetic resonance cholangiography can be used as a noninvasive and reliable imaging modality in the diagnosis of choledocholithiasis.

Keywords:

Choledocholithiasis, Ultrasonography, Magnetic Resonance Imaging, Gallstones, Sensitivity and Specificity, Diagnosis,

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1. Baron LR, Campbell WL. Nonneoplastic diseases of the bile ducts. In: Freeny PC, Stevenson GW, eds. Alimentary tract radiology. 5th ed. St. Louis: Mosby, 1994; 1294-1321. 2. Craggs MAH, Allen CM, Owens CM, et al. MR Cholangiography: Clinical evaluation in 40 cases. Radiology 1993; 189: 423-427. / 3. Guibaut L, Bret PM, Reinhold C, et al. Bile duct obstruction and choledocholithiasis: Diagnosis with MR Cholangiography. Radiology 1995; 197: 109-115. 4. Regan F, Fradin J, Khazan R, et al. Choledocholithiasis: Evaluation with MR Cholangiography. AJR 1996; 167: 1441-1445. 5. Becker CD, Grossholz M, Becker M, et al. Choledocholithiasis and büe duct stenosis: Diagnostic accuracy of MR cholangiopancreatography. Radiology 1997; 205: 523-530. 6. Soto JA, Yücel EK, Barish MA, et al. MR cholangiopancreatography after unsuccessful or incomplete ERCP. Radiology 1996; 199: 91-98. 7. Reinhold C, Bret PM. Current status of MR cholangiopancreatography. AJR 1996; 166: 1285-1295. 8. Lee MG, Lee HJ, Kim MH, et al. Extrahepatic biliary disease: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatography. Radiology 1997; 202: 663-669. 9. Chan YL, Chan ACW, Lam WWM, et al. Choledocholithiasis: Comparison of MR cholangiography and endoscopic retrograde cholangiography. Radiology 1996; 200: 85-89. 10. Irie H, Honda H, Tajima T, et al. Optimal MR cholangiopancreatographic sequences and its clinical application. Radiology 1998; 206: 379-387. 11. Brisboid D, Ploteux O, Nchimia A, et al. Value of MRCP for detection of choledocholithiasis in symptomatic patients: One year experience with a standardized high resolution breath-hold technique. JBR-BTR2001; 84: 246-261. 12. van Epps K, Regan R. MR cholangiopanreatography using HASTE sequences. Clin Radiol 1999; 54: 588-594.