Calculous disease is the most common surgical disease of the biliary system [1]. Gallstone disease is associated with 8-20% incidence of the stones migrating into the common bile duct (CBD) [2]. It is critical that in the clinical management of CBD stones these stones are detected and treated appropriately before the development of cholangitis or pancreatitis [2]. Among the non-invasive imaging techniques currently advocated for evaluating the biliary tree, ultrasonography (US) and computed tomography (CT) are the most frequently used in the initial evaluation of...

Patient population A retrospective comparative analysis was done over a period of 20 months for patients who were referred for MRCP at the Department of Radiology, John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust. Patients who did not undergo US were excluded from the study. Accordingly, a primary study group was obtained which was composed of patients with both MRCP and US of the abdomen. Depending on the diagnosis made by MRCP and US, patients were again excluded if neither technique could diagnose stone in...

General 1011 MRCP examinations were done over a period of 20 months for 983 patients, 28 patients had to repeat the examination. Of the 983 patients, 475 patients were excluded from the study because US has not been done for them. This resulted in a primary study group of 508 patients for whom both transabdominal US and MRCP were done. Within the primary study group of 508 patients, 419 patients were again excluded because neither MRCP nor US could reveal choledocholithiasis.The primary study group was,...

In the present study, US showed a poor sensitivity for diagnosing bile duct stones. Improvements in technology, combined with awareness of the difficulty in prospectively making the diagnosis, are likely contributors for an overall improvement in US sensitivity. MRCP, on the other hand, showed much higher sensitivity than US in the diagnosis of bile duct stones and the successful diagnosis seems to be less investigator dependent than ultrasonography. Although US is an excellent initial procedure for detecting biliary dilatation, MRCP is superior to US in...

Hochwald SN, Dobryansky M, Rofsky NM et al. Magnetic resonance cholangiopacreatography accurately predicts the presence or absence of cholidocholithiasis. J Gastroin Surg1998; 2:573-579. Kow L. Magnetic resonance imaging in the diagnosis of cholidocholithiasis (commentary). ANZ J Surg 2004; 74:618. Stott MA, Farrands PA, Guyer PB et al. Ultrasound of the common bile duct in patients undergoing cholecystectomy. JCU 1991; 19:73-76. Panasen P, Partanen K, Pikkarainen P et al. Ultrasonography, CT and ERCP in the diagnosis of choledochal stones. Acta Radiol 1992; 33:53-56. Metcalf AM, Ephgrave...