Virtual CT cholangioscopy: comparison with fiberoptic cholangioscopy.
OBJECTIVE
No studies comparing virtual computed tomography (CT) cholangioscopy of the common bile duct compared with fiberoptic cholangioscopy are available. The aim of our study was to evaluate the feasibility of virtual CT cholangioscopy of the common bile duct.


METHODS
The study population comprised 52 patients (25 women, 27 men; mean age 56.5, range 32 - 81) with biliopancreatic disorders. Endoscopic images were produced by a volume-rendering method and a perspective projection. The ability to detect the endoluminal view and abnormalities of the common bile duct by virtual CT cholangioscopy and fiberoptic cholangioscopy was evaluated.


RESULTS
Except for two cases (4 %), virtual CT cholangioscopy revealed excellent and moderate endoluminal visualization. There was no significant difference between the techniques (virtual CT cholangioscopy vs. fiberoptic cholangioscopy: excellent, 73 % vs. 85 %, P = 0.149; moderate 23 % vs. 15 % (P = 0.319); poor, 4 % vs. 0 %, P = 0.153). Virtual CT cholangioscopy revealed no significantly different ability to detect stenosis and obstruction of the common bile duct, compared with fiberoptic cholangioscopy. However, the ability of virtual CT cholangioscopy to detect minute papillary tumors (virtual CT cholangioscopy 30 % vs. fiberoptic cholangioscopy 100 %, P = 0.001) and stones smaller than 5 mm (virtual CT cholangioscopy 25 % vs. fiberoptic cholangioscopy 100 %; P = 0.002 was significantly less than that of fiberoptic cholangioscopy.


CONCLUSIONS
Virtual CT cholangioscopy cannot replace fiberoptic cholangioscopy completely. However, the use of this technique, instead of fiberoptic cholangioscopy, may be feasible for following up patients after biliary intervention.
Koito
K
K
Dept. of Radiology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo, 060-8543 Japan. koito@sapmed.ac.jp
Namieno
T
T
Hirokawa
N
N
Ichimura
T
T
Syonai
T
T
Yama
N
N
Mukaiya
M
M
Hirata
K
K
Sakata
K
K
Hareyama
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003137:Common Bile Duct Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016145:Endoscopy, Digestive System / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014584:User-Computer Interface