Acurácia do protocolo abreviado de colangioressonância magnética no diagnóstico de coledocolitíase

Abstract

Background: Abbreviated Magnetic Resonance Imaging (MRI) protocols have emerged to reduce the examination time of the long protocols eliminating unnecessary pulse sequences to answer a targeted clinical question, without compromising diagnostic information. The objective of this study was to evaluate the diagnostic accuracy of an abbreviated Magnetic Resonance cholangiopancreatography (A-MRCP) protocol in patients with suspected choledocholithiasis. Methods: This retrospective study evaluated patients (ages 10+ years) that performed consecutive MRCP examination from October 2019 to June 2020, with the clinical suspicion of choledocholithiasis. Readers first evaluated the biliary tree using a four-sequence A-MRCP protocol and later reviewed the entire conventional eleven-sequence MRCP. Presence of choledocholithiasis, stone size, common hepatic duct caliber, and additional findings were evaluated. Results: One-hundred fifty-two MRI scans for 148 patients with MRCP were included (62,8% female, mean 50.9 years). The prevalence of choledocholithiasis was 32.2%. The accuracy of the abbreviated MRCP protocol for choledocholithiasis was 98,7%. There was no difference between the performance of the abbreviated and conventional MRCP image sets for detection of choledocholithiasis (kappa=0.970), with a sensitivity of 98% and a specificity of 99%. There was excellent inter-reader agreement evaluating for choledocholithiasis on both imaging sets of MRCP protocols (kappa = 0.925). Conclusions: The abbreviated MRCP protocol demonstrated excellent accuracy in diagnosing choledocholithiasis, similar to the conventional protocol, with the potential to reduce examination time and improve patient comfort.