간 외 담도질환 : 전산화단층촬영담도조영술(CTC)과 자기공명담도조영술(MRC)의 활용도 평가

Extrahepatic Biliary Diseases: Comparison between CT Cholangiography and MR Cholangiography

Purpose To compare the diagnostic performances of CT cholangiography(CTC) with axial images and MR cholangiography (MRC) in the evaluation of extrahepatic biliary diseases. Materials and Methods 46(M:24,F:22) patients underwent multiplanar CTC with a multidetector row CT and MRC for suspected extrahepatic biliary diseases. We acceptid help from two radiologists reviewed CTC with axial images and MRC randomly and independently in separate sessions. The diagnostic accuracies were calculated in each reviewer with interobserver agreement value. The confidence levels of the diagnoses and conspicuities of the lesions in correct diagnoses at both CT and MRC in each reviewer were compared. Results: The overall diagnostic accuracy of CTC with axial images and MRC was 89% and 96% in reviewer 1, and 87% and 91% in reviewer 2, respectively. The difference between the two modalities was not significant (p>0.05) and the interobserver agreement was good at both modalities (0.691 at CT, 0.537 at MRC). The overall confidence levels and conspicuites were significantly higher at MRC than at CTC with axial images in both reviewers. In choledocholithiasis, the confidence was significantly high at MRC, and in common bile duct (CBD) cancer the conspicuity was significantly high at MRC. Conclusion MRC has superior diagnostic performances in the evaluation of extrahepatic biliary diseases than CTC with axial images with MDCT, especially in the diagnoses of choledocolithiasis and CBD cancer. But two method should execute mutual benefit, becaus thoese have merits and demerits in itself.