Three-dimensional spiral CT cholangiography with minimum intensity projection in patients with suspected obstructive biliary disease: comparison with percutaneous transhepatic cholangiography

Abstract

3D CTC with minIP can determine the level and cause of biliary obstruction. 3D CTC can be obtained from regular thin-section helical CT data and may be a strong competitor against diagnostic magnetic resonance cholangiography because of its superior resolution and information on adjacent soft tissues and the duct itself.

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

“…This technique depends on the hypodense content of dilated bile ducts as a (patho-)physiological negative contrast agent for differentiation from the surrounding tissue. However, for introduction of this method into dayto-day practice, breathing artefacts, slice thickness, as well as the complex procedure of segmentation of the CT data set, were the main limitation in the past [18][19][20][21][22]. The development of multidetector CT (MDCT) scanners, especially devices with more than 4 channels, led to a reduction of artefacts and voxel size.…”

“…An innovative method of CT-image reconstruction, the minimum intensity projection (MinIP), was recently introduced for visualization of biliary structures [16][17][18][19][20][21][22]. This technique depends on the hypodense content of dilated bile ducts as a (patho-)physiological negative contrast agent for differentiation from the surrounding tissue.…”

Role of magnetic resonance in characterising extrahepatic cholangiocarcinomas

“…Tuttavia queste metodiche presentano accuratezza piuttosto bassa nel determinare la causa della stenosi, non superiore al 78% per la TC [1][2][3][4][5][6][7] e molto inferiore per gli US [8,9] MRCP images were obtained with multislice (slice thickness: 4 mm without gap) half-Fourier acquisition shingle-shot turbo spin echo (HASTE) (TR: infinite, TE: 60 ms) sequences in the different spatial planes and coronal thick-slab acquisition (slice thickness: 70 mm) using heavily T2-weighted (TE: 1100 ms) turbo spin echo (TSE) sequences with multiple acquisitions (six to eight) at progressive increments of about 15°.…”

“…However, because these modalities have relatively low accuracy in determining the cause of the stenosis -not exceeding 78% for CT [1][2][3][4][5][6][7] and far lower for US [8,9] -many jaundiced patients were subjected to invasive cholangiographic methods, such as endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC), to confirm the site of obstruction and determine its nature to guide treatment. The spread of magnetic resonance imaging (MRI) has drastically changed diagnostic management of obstructive jaundice as a result of the ability of MR cholangiopancreatography (MR-CP) sequences to provide a cholangiographic map of the bile ducts.…”

“…Inoltre, in 9/23 (39%) colangiocarcinomi a sede ilare ed in 1/6 (16%) tumori del coledoco prossimale è stata documentata la presenza di ispessimento della parete delle vie biliari intra-epatiche(Figg. 1,3,4). La morfologia della stenosi duttale non ha orientato in alcun modo verso la diagnosi di natura; infatti in 22/41 (54%) colangiocarcinomi è stato evidenziato aspetto CWRM di affinamento progressivo del dotto a margini regolari, del tutto sovrapponibile a quanto rilevabile nelle stenosi infiammatorie o iatrogene(Fig.…”