Evidence map›Paper›PMID 31115625›Full record

ArticleEuropean radiology2019

Combination of CT findings can reliably predict radiolucent common bile duct stones: a novel approach using a CT-based nomogram.

Ji Hye Min, Kyung Sook Shin, Jeong Eun Lee, Seo-Youn Choi, Soohyun Ahn

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Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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3 citing papers in PubMed.

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5 · Who and what money

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5 authors.

Ji Hye MinDepartment of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kyung Sook ShinDepartment of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea. shinks@cnu.ac.kr.
Jeong Eun LeeDepartment of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Seo-Youn ChoiDepartment of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.
Soohyun AhnDepartment of Mathematics, Ajou University, Suwon, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo identify CT features that reliably predict the presence of radiolucent common bile duct (CBD) stones. MATERIALS AND

methodsThis retrospective study included 112 patients (mean age, 60.6 years) with clinically suspected CBD stones that were not visible on CT. All patients had undergone CT followed by endoscopic retrograde cholangiopancreatography (ERCP) to confirm the presence (n = 66) or absence (n = 46) of CBD stones. Two radiologists independently evaluated the CT images. Univariable and multivariable logistic regression analyses were performed to identify demographic, laboratory, and CT predictors for CBD stones. We developed a nomogram based on these results and assessed its performance.

resultsIn the multivariate analysis, CBD diameter ≥ 8 mm (odds ratio [OR], 10.12; p < 0.001), pericholecystic fat infiltration (OR, 3.76, p = 0.014), and papillitis (OR, 2.85; p < 0.049) were independent CT predictors of CBD stones. Combination of all three features had a specificity of 100%. Of these features, CBD diameter ≥ 8 mm was the best single predictor. The CT-based nomogram had an area under the curve (AUC) of 0.847 (95% confidence interval [CI], 0.777-0.916) and an accuracy of 77.7% (95% CI, 69.1-84.4%).

conclusionsThe combination of significant CT features (CBD diameter ≥ 8 mm, pericholecystic fat infiltration, and papillitis) translated into a nomogram allows a reliable estimation of CBD stone presence. It may serve as a decision support tool to determine whether to proceed to further diagnostic tests or treatment option. KEY POINTS: • CBD diameter ≥ 8 mm (odds ratio [OR] = 10.12, p < 0.001), pericholecystic fat infiltration (OR = 3.76, p = 0.014), and papillitis (OR = 2.85, p = 0.049) were independent predictors of radiolucent CBD stones. • A CBD diameter ≥ 8 mm was the best predictor of CBD stones. • A nomogram based on a combination of these three CT signs predicted the presence of CBD stones and helped classify patients that should go immediately to ERCP, those who require a further investigation, and those who can safely be managed conservatively.

Indexed as

AdultAgedAged, 80 and overArea Under CurveBiliary TractCholangiopancreatography, Endoscopic RetrogradeCommon Bile DuctFemaleGallstonesHumansMaleMiddle AgedMultivariate AnalysisNomogramsOdds RatioPredictive Value of TestsCommon bile duct calculiDiagnosisEndoscopic retrograde cholangiopancreatographyNomogramTomography, X-ray computed

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.