Nghiên cứu đặc điểm hình ảnh và giá trị của cộng hưởng từ trong chẩn đoán sỏi ống mật chủ

imaging characteristic and evaluation of MRI on the diagnosing of extra hepatic biliary stone

SUMMARY:

Objective: Study of MR imaging characteristic of the extrahepatic CBD & its value about the stone finding.

Objet and Method: Retrospectiv of 56 patients having open operation, endo and retrograde endoscopy from 10/2010 - 8/2011 at Bach mai hospital. Means: USG of Philips HD11, MRI units of Siemens Advanto and Essenza 1.5T.

Results: Among 56 operated patients for CBD stone, 6 free of stone (4 Oddi stenosis, 1 vater ampulla tumor, 1 unknown cause). MRI detected 49/50, missing 2% . In 49 positiv, 1 having 10 stones (2%), almost 3 (38%), the greatest 20 x 30mm, mainly localized at the III extrahepatic CBD portion (85/153 stones). 1 missing 5mm is at the IV portion, 49% inhomogenous mosaic form,79 strongly hyposignal on T2W. 22 patients (44.9%) associated with lithiasis in right bile duct, left 27 (55.1%), GB 13 (26.5%). Bile duct dilatation up and downward of the stone 23 (46.9%), hepatic abcess 3 (6.1%) Compare USG/MRI. USG: Se 96%, Sp 16.1%, PPV 48%, PPV 48%, Acc 52%. MRI: Se 98%,Sp 83,3%, PPV 98%, NPV 83.3%, Acc 96.4%.

Conclusion: MRI is a good means for detecting low CBD stone also for predicting its number, dimension, location and complication also Se, Acc evidently higher than USG.