ĐẶC ĐIỂM HÌNH ẢNH VÀ GIÁ TRỊ CỦA CỘNG HƯỞNG TỪ TRONG CHẨN ĐOÁN SỎI MẬT Ở BỆNH NHÂN TÁN SỎI QUA DA TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objective: The study aimed to describe the imaging characteristics and value of magnetic resonance in diagnosis of choledocholithiasis in patients with percutaneous transhepatic lithotrypsy at Hanoi Medical University hospital. Methods: A cross-sectional descriptive and prospective study was conducted on 60 choledocholithiasis patients evaluated by ultrasound (US), computed tomography (CT), and magnetic resonance cholangiopancreatography (MRCP) before undergoing percutaneous transhepatic lithotrypsy at Hanoi Medical University hospital from January 2023 to June 2024. The presence of choledocholithiasis was confirmed by laser fragmentation and mechanical basket extraction through a transhepatic tunnel. Imaging characteristics including the number of stones, type, margin characteristics, structure, signal, and location of the choledocholithiasis stones will be described on MRCP images. The value of MRCP in the diagnosis of gallstones will be assessed and compared through US and CT images. Results: Common imaging characteristics of choledocholithiasis on MRCP include: 68.3% with more than 3 stones, 71.7% pigmented stones, 68.3% stones with heterogeneous structure, 76.7% stones with increased signal on T1-weighted images, 61.7% stones with decreased signal on T2-weighted images, 98.3% biliary dilatation within the liver, 71.7% dilatation of the main biliary duct outside the liver, and dilatation of the common bile duct. The detection rates of stones on ultrasound, CT, and MRCP are 78.3%, 95.3%, and 100%, respectively. The stone detection locations on MRCP corresponded with verified actual locations during laser fragmentation and basket extraction procedures. Conclusion: MRCP is a non-invasive diagnostic method with higher choledocholithiasis detection capability than ultrasound and CT. It has the best detection and evaluation ability for the number, location and structure of choledocholithiasis within and outside the liver.