Role of CT and MRCP in Evaluation of Biliary Tract Obstruction

Springer Science and Business Media LLC - Tập 2 - Trang 1-13 - 2014
Anagha Joshi1, Kishore Rajpal1, Ketan Kakadiya1, Ashank Bansal1
1Lokmanya Tilak Munincipal Medical College & Lokmanya Tilak Munincipal General Hospital, Mumbai, India

Tóm tắt

Obstructive jaundice which is caused by bile duct obstruction can be clinically and biochemically indistinguishable from cholestatic jaundice caused by hepatocellular disease. The management of both these conditions being radically different, the principle task of the radiologist is to differentiate between hepatocellular and obstructive jaundice, using available imaging modality and help in further management. With the availability of non-invasive modality like computed tomography and magnetic resonance imaging (MRI), it is possible to diagnose obstructive jaundice early and accurately without any patient discomfort. The purpose of this article is to describe the protocol for evaluation of obstructive jaundice with use of MDCT and magnetic resonance cholangio pancreatography sequence of MRI and to describe the imaging features of the most common causes of obstructive jaundice like biliary calculi, bile duct strictures, choledochal cyst, gall bladder carcinoma, cholangiocarcinoma, primary sclerosing cholangitis, and pancreatic head carcinoma.

Tài liệu tham khảo

Rana SS, Bhasin DK, Sharma V, Rao C, Gupta R, Singh K. Role of endoscopic ultrasound in evaluation of unexplained common bile duct dilatation on magnetic resonance cholangiopancreatography. Ann Gastroenterol. 2013;26(1):66–70. • Patel HT, Shah AJ, Khandelwal SR, Patel HF, Patel MD. MR cholangiopancreatography at 3.0 T. Radiographics: a review publication of the Radiological Society of North America, Inc. 2009;29(6):1689–706. Describes and illustrates in detail 3.0T MRCP appearances of normal biliary tract anatomy, variants and benign and malignant pathologies. • Yeh BM, Liu PS, Soto JA, Corvera CA, Hussain HK. MR imaging and CT of the biliary tract. Radiographics : a review publication of the Radiological Society of North America, Inc. 2009;29(6):1669–88. Gives good knowledge about the benefits and limitations of modern MR & CT cholangiographic technique and the use of biliary specific contrast media. Romagnuolo J, Bardou M, Rahme E, Joseph L, Reinhold C, Barkun AN. Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary disease. Ann Intern Med. 2003;139(7):547–57. Wallner BK, Schumacher KA, Weidenmaier W, Friedrich JM. Dilated biliary tract: evaluation with MR cholangiography with a T2-weighted contrast-enhanced fast sequence. Radiology. 1991;181(3):805–8. Yeh BM, Breiman RS, Taouli B, Qayyum A, Roberts JP, Coakley FV. Biliary tract depiction in living potential liver donors: comparison of conventional MR, mangafodipir trisodium-enhanced excretory MR, and multi-detector row CT cholangiography–initial experience. Radiology. 2004;230(3):645–51. Marckmann P, Skov L, Rossen K, Dupont A, Damholt MB, Heaf JG, et al. Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. J Am Soc Nephrol. 2006;17(9):2359–62. O’Regan DP, Fitzgerald J, Allsop J, Gibson D, Larkman DJ, Cokkinos D, et al. A comparison of MR cholangiopancreatography at 1.5 and 3.0 tesla. Br J radiol. 2005;78(934):894–8. Park MS, Kim TK, Kim KW, Park SW, Lee JK, Kim JS, et al. Differentiation of extrahepatic bile duct cholangiocarcinoma from benign stricture: findings at MRCP versus ERCP. Radiology. 2004;233(1):234–40. Govil H, Reddy V, Kluskens L, Treaba D, Massarani-Wafai R, Selvaggi S, et al. Brush cytology of the biliary tract: retrospective study of 278 cases with histopathologic correlation. Diagn Cytopathol. 2002;26(5):273–7. Bismuth H, Majno PE. Biliary strictures: classification based on the principles of surgical treatment. World J Surg. 2001;25(10):1241–4. Marx FW Jr, Gray RK, Duncan AM, Bakhtiar L. Angiodysplasia as a source of intestinal bleeding. Am J Surg. 1977;134(1):125–30. Komi N, Takehara H, Kunitomo K, Miyoshi Y, Yagi T. Does the type of anomalous arrangement of pancreaticobiliary ducts influence the surgery and prognosis of choledochal cyst? J Pediatr Surg. 1992;27(6):728–31. Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977;134(2):263–9. Wiseman K, Buczkowski AK, Chung SW, Francoeur J, Schaeffer D, Scudamore CH. Epidemiology, presentation, diagnosis, and outcomes of choledochal cysts in adults in an urban environment. Am J Surg. 2005;189(5):527–31 discussion 31. Park DH, Kim MH, Lee SK, Lee SS, Choi JS, Lee YS, et al. Can MRCP replace the diagnostic role of ERCP for patients with choledochal cysts? Gastrointest Endosc. 2005;62(3):360–6. Levy AD, Murakata LA, Rohrmann CA Jr. Gallbladder carcinoma: radiologic-pathologic correlation. Radiographics. 2001;21(2):295–314 questionnaire, 549-55. Szklaruk J, Tamm E, Charnsangavej C. Preoperative imaging of biliary tract cancers. Surg Oncol Clin N Am. 2002;11(4):865–76. Sainani NI, Catalano OA, Holalkere NS, Zhu AX, Hahn PF, Sahani DV. Cholangiocarcinoma: current and novel imaging techniques. Radiographics. 2008;28(5):1263–87. • Chung YE, Kim MJ, Park YN, Choi JY, Pyo JY, Kim YC, et al. Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics : a review publication of the Radiological Society of North America, Inc. 2009;29(3):683–700. Illustrates detail imaging appears of various type of cholangiocarcinoma on CT and MRI and recent advance in imaging of biliary tract. Manfredi R, Masselli G, Maresca G, Brizi MG, Vecchioli A, Marano P. MR imaging and MRCP of hilar cholangiocarcinoma. Abdom Imaging. 2003;28(3):319–25. Pavone P, Laghi A, Passariello R. MR cholangiopancreatography in malignant biliary obstruction. Semin Ultrasound CT MR. 1999;20(5):317–23. Yeh TS, Jan YY, Tseng JH, Chiu CT, Chen TC, Hwang TL, et al. Malignant perihilar biliary obstruction: magnetic resonance cholangiopancreatographic findings. Am J gastroenterol. 2000;95(2):432–40. Fulcher AS, Turner MA. Orthotopic liver transplantation: evaluation with MR cholangiography. Radiology. 1999;211(3):715–22.