Sensibilidad y especificidad de la colangioresonancia magnética para el diagnóstico de coledocolitiasis. Hospital José Carrasco Arteaga. Cuenca

Abstract

Background: the American Gastrointestinal Endoscopy Society suggests classifying patients for risk of choledocholithiasis according to clinical, laboratory and ultrasound predictors. Despite this, the specificity is low, so studies suggest including other diagnostic imaging methods to avoid the performance of unnecessary endoscopic retrograde cholangiopancreatography. Objective: to establish sensitivity and specificity of magnetic resonance imaging for diagnosis of choledocholithiasis at the José Carrasco Arteaga Hospital, Cuenca. Methodology: a diagnostic test validation study was carried out, with 278 patients. All patients aged 18 years or older, without gender distinction, with suspected choledocholithiasis, were included, in whom has been performed magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography. The information was processed in PSPP version 0.10.1, EPIDAT 3.1 and EPI INFO determining the specific statistical tests. Results: the mean age of the patients was 62,53 ± 17,89 years. The distribution by sex showed a mild female predominance (52,2%). Among the non-cholecystectomized patients, the majority had gallbladder lithiasis (59,3%). In magnetic resonance cholangiopancreatography 54% of participants presented dilation of the common bile duct. After choledocholithiasis, odditis was the most frequent diagnosis (9%). Magnetic resonance cholangiopancreatography sensitivity was 79,86%, specificity 94,24%, PPV 0,93, NPV 0,82 and accuracy of 87,05% for the detection of choledocholithiasis. Conclusion: in this study, the magnetic resonance cholangiopancreatography obtained a high percentage for the diagnosis of choledocholithiasis compared with ERCP. However, this diagnosis method is not frequently required