{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:29:44Z","timestamp":1787138984351,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy of Craiova, Romania"},{"id":[{"id":"https:\/\/ror.org\/031d5vw30","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Magnetic resonance cholangiopancreatography (MRCP) enables non-invasive assessment of biliary lithiasis, duct caliber, and associated anatomical findings. Although age-dependent reference limits for common bile duct (CBD) diameter have been described, the relationships among age, gallbladder stone morphology, ductal anatomy, and CBD stones remain incompletely characterized in consecutive radiology cohorts. This study assessed age-associated MRCP patterns and imaging features associated with CBD stones. Methods: We retrospectively analyzed 242 consecutive MRCP examinations performed for biliary indications. Recorded variables included age, sex, gallbladder and CBD stone characteristics, CBD diameter, intrahepatic bile duct (IHBD) dilatation, CBD tortuosity, cystic duct morphology, periampullary diverticulum, microlithiasis, and associated pancreatobiliary findings. Ordered trend tests, group comparisons, correlation analyses, ROC analysis, and a parsimonious multivariable logistic model were used. Model 2 included six predictor parameters for 65 CBD-stone events (10.8 events per variable) and was internally validated with 2000 bootstrap resamples. Results: The cohort had a median age of 63 years (IQR 49\u201373), and 135 patients (55.8%) were female. GB stones were present in 211 patients (87.2%), and CBD stones in 65 (26.9%). Across ordered age strata, GB stone prevalence decreased (p = 0.006), whereas CBD stone prevalence increased (p = 0.038); CBD diameter and IHBD severity also increased with age (both p &lt; 0.001). CBD-positive patients had larger CBD diameters than CBD-negative patients (median 10.0 vs. 6.5 mm, p &lt; 0.001). In Model 2, CBD diameter was the strongest independent imaging correlate of CBD stones (OR 1.567 per 1 mm, 95% CI 1.310\u20131.873; p &lt; 0.001), whereas age was not independently associated after adjustment (p = 0.781). CBD diameter alone achieved an AUC of 0.853; Model 2 achieved an AUC of 0.896 and an optimism-corrected AUC of 0.884. Conclusions: Older age groups showed greater ductal involvement and larger CBD caliber in this consecutive MRCP cohort. CBD diameter was the strongest imaging correlate of CBD stones, while age and CBD diameter provided overlapping information in the adjusted model. These findings describe an observational MRCP pattern and require external validation.<\/jats:p>","DOI":"10.3390\/life16081361","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:04:12Z","timestamp":1787137452000},"page":"1361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-Associated Differences in Ductal Involvement in Biliary Lithiasis: A Consecutive MRCP Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Lucian Mihai","family":"Florescu","sequence":"first","affiliation":[{"name":"Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1524-2494","authenticated-orcid":false,"given":"M\u0103d\u0103lin","family":"M\u0103muleanu","sequence":"additional","affiliation":[{"name":"Department of Automatic Control and Electronics, University of Craiova, 200585 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3099-4637","authenticated-orcid":false,"given":"Ioana Andreea","family":"C\u00eerlig","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3990-6483","authenticated-orcid":false,"given":"Dumitru","family":"R\u0103dulescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alesandra","family":"Florescu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3650-5037","authenticated-orcid":false,"given":"Mihai-Alexandru","family":"Ene","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelia \u0218tefania","family":"Domenco","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru Marian","family":"Olaru","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, Emergency Clinical County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra Gabriela Cosmina","family":"\u021a\u00e2ru","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, Emergency Clinical County Hospital of Craiova, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1642-3587","authenticated-orcid":false,"given":"Raluca Elena","family":"Nica","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossy Vl\u0103du\u021b","family":"Teic\u0103","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0218tefan","family":"Paitici","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0954-1266","authenticated-orcid":false,"given":"Ioana Andreea","family":"Gheonea","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2570795","DOI":"10.1080\/07853890.2025.2570795","article-title":"Estimating global prevalence of gallbladder stones in general population from 2000 to 2024: Systematic review and meta-analysis","volume":"57","author":"Ning","year":"2025","journal-title":"Ann. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/j.1365-2796.2007.01783.x","article-title":"Gallstone disease","volume":"261","author":"Marschall","year":"2007","journal-title":"J. Intern. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/0140-6736(91)91972-W","article-title":"Gallstones: Pathogenesis","volume":"338","author":"Paumgartner","year":"1991","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S0016-5085(98)70266-5","article-title":"Genetic epidemiology of cholesterol cholelithiasis among Chilean Hispanics, Amerindians, and Maoris","volume":"115","author":"Miquel","year":"1998","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1111\/j.1572-0241.2004.40159.x","article-title":"The Amerindian\u2019s genes in the Mexican population are associated with development of gall stone disease","volume":"99","author":"Ramos","year":"2004","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","first-page":"e94572","article-title":"Comparative diagnostic accuracy of clinical assessment, computed tomography (CT), and magnetic resonance imaging with magnetic resonance cholangiopancreatography (MRI\/MRCP) in evaluating common bile duct stones","volume":"17","author":"Ibraheem","year":"2025","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/j.cgh.2008.05.017","article-title":"Magnetic resonance cholangiopancreatography: Current use and future applications","volume":"6","author":"Sahni","year":"2008","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1159\/000519446","article-title":"Effect of ageing on the common bile duct diameter","volume":"38","author":"Govindan","year":"2021","journal-title":"Dig. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"501","DOI":"10.4329\/wjr.v7.i12.501","article-title":"Common bile duct diameter in an asymptomatic population: A magnetic resonance imaging study","volume":"7","author":"Peng","year":"2015","journal-title":"World J. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1136\/gutjnl-2021-326106","article-title":"Definition of age-dependent reference values for the diameter of the common bile duct and pancreatic duct on MRCP: A population-based, cross-sectional cohort study","volume":"72","author":"Beyer","year":"2023","journal-title":"Gut"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.bpg.2006.05.004","article-title":"Gallstone disease: Epidemiology of gallbladder stone disease","volume":"20","author":"Shaffer","year":"2006","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1016\/j.cgh.2024.01.051","article-title":"Global epidemiology of gallstones in the 21st century: A systematic review and meta-analysis","volume":"22","author":"Wang","year":"2024","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/j.bpg.2006.05.009","article-title":"Gallstone disease: Epidemiology, pathogenesis, and classification of biliary stones (common bile duct and intrahepatic)","volume":"20","author":"Tazuma","year":"2006","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1136\/pmj.77.906.221","article-title":"Cholesterol gallstones: From epidemiology to prevention","volume":"77","author":"Acalovschi","year":"2001","journal-title":"Postgrad. Med. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1002\/jcu.1870120804","article-title":"Effect of aging on common bile duct diameter: A real-time ultrasonographic study","volume":"12","author":"Wu","year":"1984","journal-title":"J. Clin. Ultrasound"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1007\/s003300050563","article-title":"Diameter of the common bile duct in the elderly patient: Measurement by ultrasound","volume":"8","author":"Kaim","year":"1998","journal-title":"Eur. Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"ASGE Standards of Practice Committee, Buxbaum, J.L., Fehmi, S.M.A., Sultan, S., Fishman, D.S., Qumseya, B.J., Cortessis, V.K., Schilperoort, H., Kysh, L., and Matsuoka, L. (2019). ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest. Endosc., 89, 1075\u20131105.e15.","DOI":"10.1016\/j.gie.2018.10.001"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1136\/gutjnl-2016-312317","article-title":"Updated guideline on the management of common bile duct stones (CBDS)","volume":"66","author":"Williams","year":"2017","journal-title":"Gut"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1055\/a-0862-0346","article-title":"Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline","volume":"51","author":"Manes","year":"2019","journal-title":"Endoscopy"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.7326\/0003-4819-139-7-200310070-00006","article-title":"Magnetic resonance cholangiopancreatography: A meta-analysis of test performance in suspected biliary disease","volume":"139","author":"Romagnuolo","year":"2003","journal-title":"Ann. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4103\/2303-9027.180476","article-title":"Endoscopic ultrasound versus magnetic resonance cholangiopancreatography in suspected choledocholithiasis: A systematic review","volume":"5","author":"Moura","year":"2016","journal-title":"Endosc. Ultrasound"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.gie.2005.12.038","article-title":"EUS vs. MRCP for detection of choledocholithiasis","volume":"64","author":"Verma","year":"2006","journal-title":"Gastrointest. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1002\/bjs.6667","article-title":"Systematic review of endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography for suspected choledocholithiasis","volume":"96","author":"Petrov","year":"2009","journal-title":"Br. J. Surg."},{"key":"ref_24","first-page":"543","article-title":"Stage IV duodenal GIST requiring emergency pancreaticoduodenectomy\u2014Diagnosis difficulties and therapeutic options","volume":"59","author":"Mirea","year":"2018","journal-title":"Rom. J. Morphol. Embryol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1136\/bmj.294.6583.1320","article-title":"Migration of gall stones","volume":"294","author":"Taylor","year":"1987","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"971","DOI":"10.7863\/jum.2002.21.9.971","article-title":"Preoperative ultrasonographic assessment of the number and size of gallbladder stones: Is it a useful predictor of asymptomatic choledochal lithiasis?","volume":"21","author":"Costi","year":"2002","journal-title":"J. Ultrasound Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.ijsu.2013.02.009","article-title":"Gallstone size related to incidence of post cholecystectomy retained common bile duct stones","volume":"11","author":"Andrews","year":"2013","journal-title":"Int. J. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0016-5107(00)70414-7","article-title":"Choledocholithiasis: A prospective study of spontaneous common bile duct stone migration","volume":"51","author":"Frossard","year":"2000","journal-title":"Gastrointest. Endosc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e294","DOI":"10.1002\/deo2.294","article-title":"Recurrence of common bile duct stones after endoscopic clearance and its predictors: A systematic review","volume":"4","author":"Kozyk","year":"2024","journal-title":"DEN Open"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1177\/0300060518765605","article-title":"Risk factors for recurrence of common bile duct stones after endoscopic biliary sphincterotomy","volume":"46","author":"Li","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1046\/j.1365-2168.1999.01121.x","article-title":"Periampullary diverticula and pancreaticobiliary disease","volume":"86","author":"Lobo","year":"1999","journal-title":"Br. J. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1055\/s-2007-1012817","article-title":"Periampullary diverticula predispose to primary rather than secondary stones in the common bile duct","volume":"22","author":"Hall","year":"1990","journal-title":"Endoscopy"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1007\/s00268-012-1716-8","article-title":"Periampullary diverticulum may be an important factor for the occurrence and recurrence of bile duct stones","volume":"36","author":"Li","year":"2012","journal-title":"World J. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/jgh.12184","article-title":"Size and type of periampullary duodenal diverticula are associated with bile duct diameter and recurrence of bile duct stones","volume":"28","author":"Kim","year":"2013","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"236","DOI":"10.4240\/wjgs.v14.i3.236","article-title":"New common bile duct morphological subtypes: Risk predictors of common bile duct stone recurrence","volume":"14","author":"Ji","year":"2022","journal-title":"World J. Gastrointest. Surg."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/8\/1361\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T11:21:14Z","timestamp":1787138474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/16\/8\/1361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["life16081361"],"URL":"https:\/\/doi.org\/10.3390\/life16081361","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}