Multi-slice three-dimensional spiral CT cholangiography: a new technique for diagnosis of biliary diseases.
OBJECTIVE
To validate multi-slice three-dimensional spiral CT cholangiography (3-D CTC) in clinical diagnosis of biliary diseases.


METHODS
This study included 146 patients with biliary diseases, involving 73 cases of biliary tumor, 87 cases of radioparent calculus, 12 cases of post cholangio-jejunostomy and one case of congenital choledochocyst. The data of thin-slice volumetric CT scan were sent to the workstation (GE Advantage Windows 3.1). Rational 3-D CTC including maximum intensity projection, minimum intensity projection, surface shaded display, CT virtual endoscopy and ray sumption was performed. The diagnostic accuracy of 3-D CTC was compared with that of conventional CT, ultrasonography and endoscopic retrograde cholangiopancreaticography (ERCP).


RESULTS
Different biliary diseases showed distinct imaging manifestations on 3-D CTC. As a new technique for assessing the status of post cholangio-jejunostomy, 3-D CTC was superior to conventional CT, ultrasonography and ERCP in diagnosis of negative biliary calculus, extrahepatic cholangiocarcinoma, cancer embolus of the biliary duct, carcinoma of the pancreas head and periampullar carcinoma. It was also superior to conventional CT, ultrasonography or equal to ERCP in diagnosis of hilar cholangiocarcinoma, but inferior to conventional CT and ultrasonography in diagnosis of gallbladder cancer.


CONCLUSIONS
3-D CTC as a non-invasive and sensitive technique for the diagnosis of biliary diseases with high diagnostic accuracy will greatly increase the detection rate of biliary diseases.
Xu
Ai-Min
AM
Department of Radiology, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China. xuarmy@163.com
Cheng
Hong-Yan
HY
Jiang
Wen-Bin
WB
Chen
Dong
D
Jia
Yu-Chen
YC
Wu
Meng-Chao
MC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007458:Iodipamide / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods
D007458:Iodipamide; C006753:meglumine iodipamide