Accuracy of Multidetector Computed Tomographic Cholangiography In Evaluation of Causes of Biliary Tract Obstruction
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- Category: Vol. 85, December 2017
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Accuracy of Multidetector Computed Tomographic Cholangiography In Evaluation of Causes of Biliary Tract Obstruction, SANAA A. EL-TATAWY, MAGDY A. EL-SERAFY, MARYSE Y. AWADALLAH and ALI M. AL-SOUDI
Abstract
Introduction: Using MDCT cholangiography with Min1P and MPR is a quick noninvasive imaging modality that gives high diagnostic accuracy in detection of biliary stones and characterization of nature of biliary strictures. It would be mostly valuable in pre-operative cases when biopsy or therapeutic intervention is not required, or if ERCP failed.
Aim of the Work: The purpose of this study is to evaluate the accuracy of MDCT cholangiography utilizing minimum intensity projection (MinIP) reconstruction in diagnosis of causes of obstructive jaundice.
Patients and Methods: The current study was performed between September 2012 and October 2014 on 30 patients with clinical, biochemical and imaging evidences of biliary tract obstruction referred to the Radiology Department in Kasr Al-Aini University Hospital from the Departments of Tropical Medicine, Internal Medicine and Surgical Units.
Results: The results of this study showed high diagnostic accuracy of MDCT cholangiography in the group of malignant obstructive jaundice causes with a sensitivity of 100%, specificity of 92.9%, PEW of 94.1%, NPV of 100% and accuracy of 96.7%. High diagnostic accuracy in benign stricture group and faіr diagnostic accuracy in calcular group with a sensitivity of 75%, specificity of 100%, PPV of 100%, NPV of 75% and accuracy of 85.7%.
Conclusion: In our study, we concluded that reconstruction of MDCT cholangiography by MiBIP and MPR is a good noninvasive imaging modality that offers fair diagnostic accuracy in detection of biliary stones and high diagnostic accuracy in differentiation between benign and malignant biliary strictures, which allows single-step evaluation of the biliary system апд the surrounding structures with ideal assessment of the lesion site and extension. It cannot be expected to challenge the optimum results of ERCP as it does not allow direct access to biopsy or therapeutic actions.