ROLE OF MULTIDETECTOR ROW COMPUTED TOMOGRAPHY IN EVALUATION OF BILIARY TRACT OBSTRUCTIVE JAUNDICE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2015, Vol 2, Issue 13
Abstract
INTRODUCTION: Obstructive jaundice is a type of jaundice in which there is blockage of flow of bile from the liver to the intestine resulting in redirection of excess bile and it’s by-products like bilirubin into the blood. It can lead to complications like ascending cholangitis, hepatorenal syndrome and malabsorption, hence requiring urgent surgical intervention. The role of a radiologist therefore is important in early diagnosis and in accurately delineating the level and the cause of obstruction, thus helping in staging as well as preoperative assessment of tumor resectability. The search for noninvasive diagnostic tools is an emerging medical need, in order to avoid invasive, costly and physician-intensive procedures such as endoscopic retrograde cholangiopancreatography (ERCP). (1) Ultrasound is a non-invasive and cost effective imaging technique available for evaluating biliary tract obstruction. Ultrasound demonstrates the presence of biliary tract obstruction by identifying dilated bile ducts but has a sensitivity of 55%-95% and specificity of 71%-96 %. (2) The role of magnetic resonance cholangiography (MRCP) is well established in this field as the most reliable noninvasive technique. (3) However, some drawbacks, such as contraindication in patients with pacemakers and ferromagnetic implants, for claustrophobic patients, long examination times exceeding 30 minutes and limited availability of scanners still limit its use. MRCP is expensive and has limitations such as interference from intraluminal gas, pneumobilia and flow artifacts.(4) In the past, axial conventional CT could not provide adequate information of biliary abnormalities since the total depiction of these ducts was not suitable for evaluation in axial planes. (5) MDCT's ability to obtain volume dataset with sub-millimeter spatial resolution allows the optimal display of bile duct by using multiplanar reconstruction (MPR) and minimal intensity projection (MinIP) without compromising on image quality. The combined use of MPR and MinIP techniques significantly improves the visualization of the biliary ducts and their site of confluence compared with those obtained by axial CT. (5) The purpose of the present study is to evaluate the utility of MDCT in suspected patients with biliary tract obstruction by establishing the cause of obstruction, location of obstruction and to differentiate between benign and malignant causes by comparing with ERCP, surgical or histopathological findings.
Authors and Affiliations
Akshaya Reddy Erasu, Indira N, Ram Prakash H. V
Keywords
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- EP ID EP226764
- DOI 10.18410/jebmh/2015/276
- Views 98
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