MDCT Cholangiography with Volume Rendering for the Assessment of Patients with Biliary Obstruction

Ahmetoğlu, Ali; Koşucu, Polat; Kul, Sibel; Dinç, Hasan; Sarı, Ahmet; Arslan, M; Alhan, Etem; Gümele, Halit Reşit

doi:10.2214/ajr.183.5.1831327

Cited by 47 publications

(38 citation statements)

References 21 publications

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“…S W Kim, H C Shin, H C Kim et al obstructive lesions. Undoubtedly, the recently introduced MDCT cholangiography using advanced postprocessing techniques allows for a more accurate diagnosis of biliary obstruction [13][14][15][16]. Nevertheless, our results using the axial images of a MDCT showed good accuracy for the detection of biliary obstruction; the results are comparable with a previous study using both multiplanar and minimum intensity reformations [6]; however, because an aetiological diagnosis was not made in our study, an exact comparison between the two studies may be limited.…”

Section: Discussionsupporting

confidence: 62%

“…They reported that the clinical diagnosis of acute cholangitis could be confirmed by demonstration of biliary obstruction using CT examination in 87% of patients. Subsequently, with advances in hardware and software technology, CT has been regarded as a reliable imaging modality with good diagnostic accuracy for biliary obstruction [5,6,[13][14][15][16]. In this study, we achieved a sensitivity of 80-84%, a specificity of 97-98% and an accuracy of 90-92% in the CT detection of biliary G, group; TS, total score.…”

Section: Discussionmentioning

confidence: 66%

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Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Kim¹,

Shin²,

Kim³

et al. 2012

BJR

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Objective: The aim of this study was to retrospectively assess the diagnostic performance of multidetector CT (MDCT) for the diagnosis of acute cholangitis using a new scoring method. Methods: Of 80 patients with suspected biliary disease who underwent biphasic CT and endoscopic retrograde cholangiography, 39 were diagnosed as having acute cholangitis (Group 1) and 41 patients were classified as suspected biliary disease (Group 2). 100 agematched patients without evidence of biliary disease were selected randomly as a control group (Group 3). Each patient's axial scan was scored by two independent radiologists for the extent of transient hepatic attenuation difference, the presence of biliary dilatation and identification of a biliary obstructive lesion. The difference in the scores among the three groups was evaluated and the optimal cut-off score for the diagnosis of acute cholangitis was determined. Interobserver agreement was also evaluated. Results: The total scores (mean¡standard deviation) for Groups 1, 2 and 3 were 7.0¡2.0, 4.4¡2.4 and 0.9¡1.2, respectively, for Reviewer 1 and 7.2¡2.7 and 0.7¡1.1, respectively, for Reviewer 2. Significant differences were found for the subscores and the total scores among the three groups (p,0.001). Using a cut-off score of $5, the sensitivity and specificity for diagnosing acute cholangitis were 84.6% and 83.7%, respectively, for Reviewer 1 and 89.7% and 83.7%, respectively, for Reviewer 2. Agreement for the subscores between readers was good to excellent (k50.74-0.86). Conclusion: Based on dynamic MDCT and the described CT scoring method, the diagnosis of acute choangitis can be made with high sensitivity and specificity.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 66%

Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Kim¹,

Shin²,

Kim³

et al. 2012

BJR

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“…In a large study, CTC was superior to conventional CT or US and equal to endoscopic retrograde cholangiopancreatico graphy (ERCP) for the diagnosis of HCC [102] . In another smaller study, the sensitivity and specificity of CTC for malignant biliary obstruction were both 94% [103] . One of the limitations of CTC is that optimal imaging quality depends on the secretory function of the liver [104] .…”

Section: Computed Tomography (Ct)mentioning

confidence: 89%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

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Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/ magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study.

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“…Chen et al found accuracy for intrahepatic CCC of 80% for CEUS and 67.5% for CT [46]. CT cholangiography has a diagnosis accuracy of up 94 % for intrahepatic CCC [47]. Another constant element is the retraction of the capsule (in approximately 20% of the patients) due to the fibrotic nature of the tumor [48].…”

Section: Pathologymentioning

confidence: 99%

Ultrasonography of the biliary tract â€“ up to date. The importance of correlation between imaging methods and patientsâ€™ signs and symptoms.

et al. 2015

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Ultrasonography is generally accepted and performed as a first choice imaging technique in patients with jaundice. The method allows the discrimination between cholestatic and mechanical jaundice. The existing procedures are multiple: gray scale, Doppler, i.v. contrast enhancement, elastography, tridimensional ultrasonography, each of these with different contribution to the positive and differential diagnosis regarding the nature of the jaundice. The final diagnosis is a multimodal one and the efficiency is dependent on the level of the available technology, the examiner's experience, the degree and modality of integration of the data within the clinical context, as well as on the portfolio of available imaging procedures. This review shows the main ultrasonographic methods consecrated in the evaluation of the biliary tree. It also underlines the integrated character of the procedures, as well as the necessity to correlate with other imaging methods and the clinical situation.

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MDCT Cholangiography with Volume Rendering for the Assessment of Patients with Biliary Obstruction

Abstract: MDCT cholangiography with volume rendering is a noninvasive and fast imaging technique with high sensitivity and specificity for the diagnosis of the cause of biliary tree obstruction. It is a promising diagnostic tool for the assessment of patients with bile duct obstructions.

Cited by 47 publications

References 21 publications

Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Ultrasonography of the biliary tract â€“ up to date. The importance of correlation between imaging methods and patientsâ€™ signs and symptoms.

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