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| Evaluated the value of diagnostic MRCP in patients with cholangiopancreatic disease by ROC |
| WU Mei1, GUO Qi-yong1, SUN Chong-peng2, MA Chun-mei1, CHEN Sheng-li3 |
| 1. Department of Radiology, the Second Affiliated Hospital of China Medical University, Shenyang 110004, China;2. Department of Radiology, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China;3. Department of Radiology, the First People’s Hospital of Guangzhou, Guangzhou 510180, China |
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Abstract Objective: To evaluate the value of diagnostic ultrasound, CT and MRCP in patients with cholangiopancreatic disease by receiver operating characteristic curves(ROC), and introduce the principle of ROC simply. Methods: One hundred and five patients suspected with cholangiopancreatic disease were collected. All patients were studied with MR. Of them, 65 patients underwent US examination. CT were performed in another 59 patients, of them, ultrasound was performed in 31 patients. Pathological results, operating findings or clinical and laboratorial examination results were the reference standard. Images were interpreted blindly to the reference standard. True positive rate and false positive rate were calculated respectively. We analysed the data with ROC. According to location and cause of the obstruction, sensitivity, specificity and likelihood ratio of MRCP, US and CT were calculated respectively. Chi-square test and Fisher test were used as statistical methods. Results: ROC curve showed MRCP curve lie in the top left corner. Area under the ROC curve(AZ) of ultrasound, CT and MRCP were 0.981, 0.901 and 0.985 respectively. All AZ value of them was higher than 0.9. But there was no significant difference between MRCP and CT(Z=0.75, P>0.05). According to location and cause of the obstruction, MRCP, US and CT had different diagnostic ability. ①The sensitivity of MRCP in distinguishing the various pancreato-biliary tumors was significantly higher than that of US and CT(P<0.05). ②The sensitivity of MRCP in diagnosing pancreato-biliary stones was significantly higher than that of US and CT?穴χ2=10.058 and 5.046, P<0.05). The sensitivity of MRCP, US and CT in diagnosing choledocholithiasis were 92%, 39% and 62% respectively. There was significant difference between MRCP and US(χ2=17.412, P<0.001). Conclusion: ROC analysis is an objective index for comparing and evaluating difference in efficiency of two or more imaging diagnostic methods. MRCP has better discriminatory power than does US and CT for the work-up of obstructive jaundice disease. MRCP has better discriminatory power than does US and CT in diagnosing the malignant pancreato-biliary obstruction and pancreato-biliary stones.
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Received: 01 January 1900
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2006, Vol. 17 
