Accuracy of the Multislice CT in Diagnosis of Biliary Tract Obstruction

Abstract

Background: The recent implementation of multidetector computed tomography (MDCT) scan and post-processing image reconstruction techniques has facilitated a better visualization of the biliary system. With multiplanar reconstruction technique, the biliary duct anatomy can be displayed in various planes. Moreover, minimal intensity projection technique enables us to depict a small biliary duct and pancreatic duct more clearly. Aim of the study: This study aims to show the accuracy of MDCT in diagnosis of biliary obstruction. Materials and Methods; MDCT cholangiographs of 90 patients with clinically suspected biliary tract obstruction were retrospectively reconstructed and reviewed. The causes of obstruction identified by MDCT were divided into three groups including calculus, benign stricture, and malignancy. Final diagnosis was based on pathological diagnosis or PTC or endoscopic retrograde cholangiopancreatography or follow-up. The MDCT diagnosis and final diagnosis were compared. Results: The sensitivity, specificity, positive predictive value, and negative reductive value of MDCT cholangiography for detection of calculus, benign stricture, and malignancy were 88.8-100%, except for sensitivity and positive predictive value for detection of benign stricture, which were 66.7% and 66.7% respectively. Conclusion; MDCT cholangiography is a fast, noninvasive technique that offers high diagnostic accuracy in evaluation of cause of biliary tract obstruction.