Prospective comparison of transcutaneous 3-dimensional US cholangiography, magnetic resonance cholangiography, and direct cholangiography in the evaluation of malignant biliary obstruction

Preoperative evaluation of the longitudinal spread of extrahepatic bile duct cancer using multidetector computed tomography

“…The traditional approach to assessing the longitudinal spread of bile duct cancer is by direct cholangiography. Several reports [11, 12, 14], however, have proposed that MRC can provide projectional images from the biliary tree that are similar to those obtained by direct cholangiography without invasive intervention or the administration of contrast agents. Although CT has been widely used in the diagnosis of bile duct cancer since 1980, the accuracy of its diagnosis is difficult to assess [21, 22].…”

Minimum intensity projections of the biliary system using 16-channel multidetector computed tomography in patients with biliary obstruction: comparison with MRCP

“…Thus a distinct imaging method is required for adequate diagnostic assessment of the biliary tract and the source of obstruction [1]. The established methods so far are percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography (ERCP) [2,3] or magnetic resonance cholangiopancreatography (MRCP) [3][4][5][6], while three-dimensional ultrasound cholangiography is still limited [7]. These methods are dedicated for visualization of the biliary tract and represent highly sophisticated diagnostic tools.…”

Biliary Ductal Involvement of Hilar Cholangiocarcinoma

“…9 The prognosis of this tumor is very poor, and the best therapeutic approach is surgical resection, despite the fact that a majority of patients have an unresectable disease at the time of diagnosis. 4,11 Subsequently, MRC has established preoperative or preprocedural planning modality and replaced diagnostic ERC because it was noninvasive and able to provide projectional images similar to direct cholangiography without the administration of an intravenous contrast agent or ionizing radiation. 10 Many imaging techniques may be used to evaluate the biliary tree, including ultrasonography, CT, CT cholangiography using a biliary contrast agent, MR cholangiography, ERC, and percutaneous transhepatic cholangiography.…”

“…The primary goal of preoperative examinations is to first exclude the established criteria of unresectable tumors, and then to define the tumor spread, to identify the level of obstruction, and to show any other combined findings. 5,6,11,12 Computed tomography has been a widely used noninvasive examination method for assessing the hilar mass, local parenchymal extension, evidence of intrahepatic metastatic disease, lymph adenopathy, peritoneal spread, and vessel involvement in hilar cholangiocarcinoma. 4 Direct cholangiography had been regarded as the most accurate preoperative diagnostic modality for the assessment of the longitudinal extension of hilar cholangiocarcinoma.…”