Comparison of the Diagnostic Value of MRCP, CT, and Ultrasonography in Choledochal Stones with the Results of ERCP: Evidence from 1152 Case

Abstract

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP), computed tomography (CT), and ultrasonography (US) are widely used in the diagnosis of choledochal stones. This study aims to determine the sensitivity and diagnostic contribution of US, CT, and MRCP in detecting common bile duct stones and to compare them with ERCP. Materials and Methods: The study included 1152 patients who underwent ERCP diagnosed with choledochal stones. Initially, each patient underwent USG, CT, and MRCP. ERCP was performed 2-7 days later. The results were compared with the ERCP results. Sensitivity, specificity, positive predictive value (PPV), Negative Predictive Value (NPV), and F1 score were calculated. Results: Compared to ERCP, the most effective method in the diagnosis of choledocholithiasis is MRCP (F score: 0.84), CT (F score: 0.73), MR+BT (F score: 0.75), MR+BT+USG (F score: 0.55), and US (F score: 0.43). Conclusions: ERCP is the gold standard in treating stones in the common bile duct. However, since this method is invasive, its use for diagnostic purposes has decreased due to the possibility of complications. In diagnosing common choledochal stones, MRCP alone is sufficient regardless of other imaging methods.