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

Noda, Yoshifumi; Goshima, Satoshi; Kojima, Toshihisa; Kawaguchi, Shimpei; Kawada, Hiroshi; Kawai, Nobuyuki; Koyasu, Hiromi; Bae, Kyongtae T.

doi:10.1007/s00261-016-0990-6

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…The present retrospective chart review in a regional single hospital indicated that (i) the risk factors for PEP were a younger age, female sex, performance of pancreatography, and a history of pancreatitis and (ii) the incidence of PEP were not different between regular hours and off hours. The complication rate of PEP in the present study of the patients without the previous ERCP was 10.2%, which is similar to previous reports (3-15% among ERCP procedures) [5,13,14,19]. The present study evaluated 8 factors using a multivariate analysis: 6 factors selected by the stepwise method (age, sex, body mass index, history of pancreatitis, diagnostic or therapeutic ERCP, and pancreatography) and 2 essential factors (administration of diclofenac suppository and performance of MRCP before ERCP).…”

Section: Discussionsupporting

confidence: 92%

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Risk Factors for Post-Endoscopic Retrograde Pancreatography Pancreatitis: A Retrospective Chart Review in a Regional Hospital in Japan

et al. 2019

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Background: Endoscopic retrograde pancreatography (ERCP) is sometimes complicated by post-ERCP pancreatitis (PEP), which is a severe adverse effect. Objective: The present study was performed to (i) evaluate the risk factors for PEP and (ii) compare the risk of PEP after ERCP performed in the off hours versus regular hours. Methods: This retrospective study included 374 patients who underwent ERCP from January 2013 to December 2017. Among these patients, 38 (10.2%) developed PEP. The potential risk factors for PEP were evaluated by multivariate regression analysis, and the risk of PEP was compared between ERCP performed during regular hours and off hours. Results: The independent risk factors for PEP were a relatively younger age (< 75 years; p = 0.024), female sex (p = 0.002), a history of pancreatitis (p = 0.044), and performance of pancreatography (p = 0.010). Use of a diclofenac suppository and performance of pancreatic stenting were not preventive for PEP after ERCP. The complication rate of PEP did not differ between ERCP performed during the off hours versus regular hours. Conclusions: A relatively younger age (< 75 years), female sex, a history of pancreatitis, and performance of pancreatography were potential risk factors for PEP, whereas the risk of PEP was not different between ERCP performed during the off hours versus regular hours.

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Section: Discussionsupporting

confidence: 92%

“…Post-ERCP pancreatitis (PEP) is one of the most serious complications of ERCP. In recent years, computed tomography and/or magnetic resonance cholangiopancreatography (MRCP) have become more highly applicable diagnostic approaches for pancreatic and biliary system diseases than ERCP [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Post-Endoscopic Retrograde Pancreatography Pancreatitis: A Retrospective Chart Review in a Regional Hospital in Japan

et al. 2019

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“…The patient can have abdominal pain, fever, jaundice and other manifestations, and choledochal dilatation can be seen by abdominal B-ultrasound in symptomatic choledocholithiasis, which is easily diagnosed. In contrast, most cases of secondary choledocholithiasis do not have symptoms[7] and are often missed in diagnosis. On one hand, this may lead to the persistent presence of common bile duct stones and related complications.…”

Section: Introductionmentioning

confidence: 99%

Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis

Mei¹,

Chen²,

Peng-fei³

et al. 2019

WJCC

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BACKGROUNDGamma-glutamyltransferase (GGT) is one of the most important laboratory tests for the evaluation of liver damage. Through a long-term clinical observation of patients with secondary asymptomatic choledocholithiasis, we found that most patients had abnormal GGT serum levels.AIMTo investigate the combination of serum GGT and alkaline phosphatase (ALP) in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis.METHODSIn this retrospective cohort study, the clinical data of 829 patients with cholecystolithiasis admitted to the Third Affiliated Hospital of Zunyi Medical College from August 2014 to August 2017 were collected. Among these patients, 151 patients had secondary asymptomatic choledocholithiasis and served as the observation group, and the remaining 678 cholecystolithiasis patients served as the control group. Serum liver function indexes were detected in both groups, and the receiver operating characteristic (commonly known as ROC) curves were constructed for markers showing statistical significances. The cutoff value, sensitivity, and specificity of each marker were calculated according to the ROC curves.RESULTSThe overall incidence of asymptomatic choledocholithiasis secondary to cholecystolithiasis was 18.2%. The results of liver function indexes including serum aspartate aminotransferase, alanine aminotransferase, direct bilirubin and total bilirubin levels showed no significant differences between the two groups (P > 0.05). However, the serum GGT and ALP levels were significantly higher in the observation group than in the control group (P < 0.05). The ROC curve analysis showed that the area under the curve was 0.881 (95%CI: 0.830-0.932), 0.647 (95%CI: 0.583-0.711) and 0.923 (95%CI: 0.892-0.953) for GGT, ALP, and GGT + ALP, respectively. The corresponding cut-off values of GGT and ALP were 95.5 U/L and 151.5 U/L, sensitivity were 90.8% and 65.1%, and specificity were 83.6% and 59.8%, respectively. The sensitivity and specificity of GGT + ALP were 93.5% and 85.1%, respectively.CONCLUSIONAn abnormally elevated serum GGT level has an important value in the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis. The combination of serum GGT and ALP has better diagnostic performance. As a convenient, rapid and inexpensive test, it should be applied in secondary asymptomatic choledocholithiasis routine screening.

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“…In our center, MRCP images are acquired by a 1.5‐T MR imaging system (Magnetom Sempra, Siemens, Erlangen, Germany). We reconstructed a multi‐slice two‐dimensional (2D) acquisition based on respiratory‐triggered heavily T2‐weighted fast spin echo sequences in the coronal plane 17 . The imaging plane was decided from the scout image based on the initial axial T2‐weighted images, with the first acquisition aligned with the bile duct in the pancreatic head portion.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of an artificial neural network algorithm based on thick‐slab magnetic resonance cholangiopancreatography images for the automated diagnosis of common bile duct stones

Hou

Park

et al. 2021

J of Gastro and Hepatol

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Background and Aim Magnetic resonance cholangiopancreatography (MRCP) can accurately diagnose common bile duct (CBD) stones but is laborious to interpret. We developed an artificial neural network (ANN) capable of automatically assisting physicians with the diagnosis of CBD stones. This study aimed to evaluate the ANN's diagnostic performance for detecting CBD stones in thick‐slab MRCP images and identify clinical factors predictive of accurate diagnosis. Methods The presence of CBD stones was confirmed via direct visualization through endoscopic retrograde cholangiopancreatography (ERCP). The absence of CBD stones was confirmed by either a negative endoscopic ultrasound accompanied by clinical improvements or negative findings on ERCP. Our base networks were constructed using state‐of‐the‐art EfficientNet‐B5 neural network models, which are widely used for image classification. Results In total, 3156 images were collected from 789 patients. Of these, 2628 images from 657 patients were used for training. An additional 1924 images from 481 patients were prospectively collected for validation. Across the entire prospective validation cohort, the ANN achieved a sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 93.03%, 97.05%, 97.01%, 93.12%, and 95.01%, respectively. Similarly, a radiologist achieved a sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy 91.16%, 93.25%, 93.22%, 90.20%, and 91.68%, respectively. In multivariate analysis, only bile duct diameter > 10 mm (odds ratio = 2.45, 95% confidence interval [1.08–6.07], P = 0.040) was related to ANN diagnostic accuracy. Conclusion Our ANN algorithm automatically and quickly diagnoses CBD stones in thick‐slab MRCP images, therein aiding physicians with optimizing clinical practice, such as whether to perform ERCP.

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

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

Cited by 5 publications

References 14 publications

Risk Factors for Post-Endoscopic Retrograde Pancreatography Pancreatitis: A Retrospective Chart Review in a Regional Hospital in Japan

Risk Factors for Post-Endoscopic Retrograde Pancreatography Pancreatitis: A Retrospective Chart Review in a Regional Hospital in Japan

Combination of serum gamma-glutamyltransferase and alkaline phosphatase in predicting the diagnosis of asymptomatic choledocholithiasis secondary to cholecystolithiasis

Efficacy of an artificial neural network algorithm based on thick‐slab magnetic resonance cholangiopancreatography images for the automated diagnosis of common bile duct stones

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