Valor de la ultrasonografía endoscópica y de la colangioresonancia magnética en el diagnóstico de la coledocolitiasis

Abstract

RESUMEN: Objetivos: Determinar el valor diagnóstico de USE y CRM en la coledocolitiasis, en pacientes con pancreatitis aguda (grupo 1), y sospecha de coledocolitiasis (grupo 2).

Métodos: Los pacientes fueron evaluados de forma prospectiva, mediante USE y CRM. Se calculó la sensibilidad, especificidad, valores predictivos positivo y negativo. Para analizar la capacidad del método diagnostico se calculó el Índice de Youden, el test de McNemar se utilizó para determinar la asociación entre los resultados de las pruebas.

Resultados: Un total de 70 pacientes (grupo 1 N=27, grupo 2 N=43) fueron analizados, se diagnosticó coledocolitiasis en 26. Encontramos con un IC del 95%, sensibilidad de la USE y CRM en la coledocolitiasis de 73,08% y 88,46%, especificidades 84,09% y 93,18%, respectivamente; con VPP para USE del 73,08% y 88,46% para CRMN, VPN 84,09% para USE y 93,18%, para CRMN.

Conclusiones: En nuestra serie hemos encontrado que ambas pruebas tienen elevada sensibilidad, especificidad, valor predictivo positivo y negativo sin encontrar diferencias estadísticamente significativas.

ABSTRACT: Objectives: Determine the diagnostic value of EUS and MRC in choledocholithiasis in patients with acute pancreatitis (group 1), and suspected choledocholithiasis (group 2).

Methods: Patients were prospectively evaluated by EUS and CRM. Sensitivity, specificity, positive and negative predictive values were calculated. To test the ability of diagnostic method the Youden index, McNemar's test was used to determine the association between test results was calculated.

Results: A total of 70 patients (group 1 N = 27, group 2, N = 43) were analyzed. Choledocholithiasis was diagnosed in 26. We found with CI 95%, sensitivity of MRC and EUS in choledocholithiasis of 73.08% and 88.46%, specificity 84.09% and 93.18%, respectively; PPV for EUS of 73.08% and 88.46% for CRM, PNV 84.09% to USE and 93.18% in MRC.

Conclusions: In our study we observed both tests have high sensitivity, specificity, positive and negative predictive value but no statistically significant difference.