Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Comparative Study between Digital Tomosynthesis and Endoscopic Retrograde Cholangiopancreatography for the Evaluation of Common Bile Duct Stones: Focus on Detection and Stone Conspicuity

총담관결석 평가에서 디지털단층영상합성법과 내시경역행담췌관조영술의 비교 연구

  • Huh, Ji-Mi (Department of Radiology, School of Medicine, Ewha Womans University University) ;
  • Baek, Seung-Yon (Department of Radiology, School of Medicine, Ewha Womans University University) ;
  • Hwang, Yun-Mi (Department of Radiology, School of Medicine, Ewha Womans University University) ;
  • Lee, Jeong-Kyong (Department of Radiology, School of Medicine, Ewha Womans University University) ;
  • Kim, Yoo-Kyung (Department of Radiology, School of Medicine, Ewha Womans University University) ;
  • Yi, Sun-Young (Department of Internal Medicine and Medical Research Institute, School of Medicine, Ewha Womans University)
  • 허지미 (이화여자대학교 의학전문대학원 영상의학과학교실) ;
  • 백승연 (이화여자대학교 의학전문대학원 영상의학과학교실) ;
  • 황윤미 (이화여자대학교 의학전문대학원 영상의학과학교실) ;
  • 이정경 (이화여자대학교 의학전문대학원 영상의학과학교실) ;
  • 김유경 (이화여자대학교 의학전문대학원 영상의학과학교실) ;
  • 이선영 (이화여자대학교 의학전문대학원 내과학교실)
  • Published : 2011.11.01
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Abstract

Purpose: To compare digital tomosynthesis with endoscopic retrograde cholangiopancreatography (ERCP) for the evaluation of common bile duct (CBD) stones as a complementary diagnostic tool. Materials and Methods: Ninety six consecutive patients clinically suspected of having CBD stones underwent ERCP and digital tomosynthesis over 22 months, from December, 2008 to May, 2010. Fourteen patients were excluded. Therefore 82 patients were included in this study. The images were retrospectively reviewed to compare the results with the final analysis based on the consensus of two abdominal radiologists. An evaluation of the presence of CBD stones was followed by a determination of the margins for the stones, scored with a five-point conspicuity scale. Results: Among the 82 patients, 54 collectively had 89 CBD stones and 28 had no stones. The sensitivity and specificity for the detection of CBD stones were 91.0% and 80.6% for ERCP, 92.1% and 93.5% for digital tomosynthesis, respectively. The average score was 3.29 for ERCP and 3.89 for digital tomosynthesis in 77 similar detected stones. Digital tomosynthesis demonstrated significantly better conspicuity than ERCP (p = 0.001). Conclusion: Digital tomosynthesis is an effective and complementary diagnostic method for the evaluation of CBD stones.

목적: 총담관결석 평가에 디지털단층영상합성법(digital tomosynthesis)과 내시경역행담췌관조영술(endoscopic retrograde cholangiopancreatography; 이하 ERCP)의 상호 보완적인 진단 방법으로서의 가치를 비교하고자 하였다. 대상과 방법: 2008년 12월부터 2010년 5월까지 ERCP와 digital tomosynthesis를 동시에 시행한 환자 중 총담관결석 증상이 의심되는 96명의 환자를 대상으로 하였다. 이 중 14명이 제외되어 82명의 환자가 연구에 포함되었다. 두 명의 영상의학과 의사가 ERCP와 digital tomosynthesis 영상을 후향적으로 분석하였다. 먼저 총담관결석의 유무를 평가하였고, 두검사 방법에서 동시에 결석이 발견된 경우에는 결석의 경계를 1점에서 5점으로 척도를 정하였다. 결과: 82명의 환자 중 54명의 환자가 89개의 총담관결석이 있었으며 28명의 환자는 결석이 없었다. 총담관결석 진단에서 ERCP의 민감도, 특이도는 91.0%, 80.6%이며 digital tomosynthesis는 92.1%, 93.5%였다. 두 진단 방법에서 동시에 발견된 77개의 총담관결석 경계의 정확도에 대한 평균 점수는 ERCP에서 3.29이며 digital tomosynthesis에서 3.89였다. 총담관결석 경계의 정확도는 digital tomosynthesis에서 통계적으로 유의하게 높았다(p = 0.001). 결론: 총담관결석을 평가하는 데 있어 digital tomosynthesis는 효과적이며 상호 보완적인 진단 방법이 될 수 있다.

Keywords

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