Korean J Gastrointest Endosc > Volume 35(4); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(4): 235-242.
총담관결석 진단에 대한 다검출 나선 전산화단층촬영의 역할: 내시경 역행성 담췌관조영술과의 비교
김동일ㆍ이홍식ㆍ김진남ㆍ정성우ㆍ구자설ㆍ임형준ㆍ진윤태ㆍ전훈재ㆍ엄순호ㆍ이상우ㆍ최재현ㆍ김창덕ㆍ이승화*ㆍ류호상
고려대학교 의과대학 내과학교실, 소화기내과, *영상의학교실
Role of Multidetector Computerized Tomography (MDCT) in Identification of Common Bile Duct Stone: Comparison with ERCP
Dong Il Kim, M.D., Hong Sik Lee, M.D., Jin Nam Kim, M.D., Sung Woo Jung, M.D., Ja Seol Koo, M.D., Hyung Joon Yim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D., Seung Hwa Le
Department of Internal Medicine, Institute of Digestive Disease and Nutrition and *Department of Radiology, Korea University College of Medicine, Ansan, Korea
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. (Korean J Gastrointest Endosc 2007;35:235-242)
Key Words: Multidetector computerized tomography (MDCT), ERCP, Choledocholithiasis
주요어: 다검출 나선 전산화단층촬영, 내시경 역행성 담췌관조영술, 담관결석
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