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At least 307 records · Page 17Linked to original sources
PubMed1995

Three-dimensional reconstruction of the biliary tract using spiral computed tomography.

Spiral computed tomography (SCT) is a recently introduced technique which enables scanning of one large volume with no interscan intervals. Three-dimensional reconstruction using this technique is emerging as an effective means of identifying complex anatomical relationships. Ninety-two patients with cholecystolithiasis including ten with choledocholithiasis were investigated. All underwent SCT after oral and intravenous infusion cholangiography (IVC-SCT) and 22 were also examined by endoscopic retrograde cholangiography (ERC). IVC-SCT showed significantly more anatomical detail than conventional intravenous infusion cholangiography (IVC). The junction between the cystic duct and the common bile duct could be identified before surgery in 19 of 22 patients undergoing ERC, in 18 of 22 receiving IVC-SCT and in five of 22 undergoing IVC. Significant differences were noted between IVC-SCT, ERC and conventional IVC. Three-dimensional surface reconstruction of the biliary tract is useful in the evaluation of anatomical relationships between the cystic duct and the common bile duct (clearly seen in 86 per cent of cases). Three-dimensional reconstruction using SCT scanning is useful for anatomical assessment before laparoscopic cholecystectomy.

Adult↗
PubMed2002

Thallium-201 accumulation in a patient with brain abscess.

A 57-year-old man was admitted to our hospital because of high fever and generalized tonic seizure. Brain magnetic resonance imaging (MRI) delineated multiple abnormal intensity areas. Thallium-201 (201Tl) scintigraphy revealed abnormal uptake in the brain. The imaging findings did not allow definitive exclusion of brain tumor, even though brain abscess was the more strongly suspected diagnosis. As the patient improved, the multiple abnormal intensity areas in the brain on MRI and the abnormal areas of accumulation on 201Tl scintigraphy were reduced, and eventually completely disappeared. A final diagnosis of brain abscess was therefore made. Since relatively few studies have reported 201Tl accumulation in cases of brain abscess, we report here our patient in whom the changes in the accumulation of 201Tl in a brain abscess were observed over time.

Brain Abscess↗
PubMedDate not supplied

Virtual CT cholangiography in patients with choledocholithiasis.

BACKGROUND: We evaluated the feasibility and accuracy of virtual computed tomographic cholangiography (VCTC) in detecting choledocholithiasis and imaging anatomic variations of the biliary tree. METHODS: Thirty-three consecutive patients with clinical and biological signs of choledocholithiasis underwent spiral CT after intravenous infusion of iotroxindimeglumine. Patients with total serum bilirubin levels above 3 mg/dL were not included in this study. Spiral data sets were used to construct intralumenal images of the biliary tree. The images were reviewed by two abdominal radiologists. The biliary ducts were divided into three segments, so the analysis was based on 99 segments. The diagnosis obtained by VCTC was compared with the final diagnosis established by endoscopic retrograde cholangiography or intraoperative cholangiography. RESULTS: VCTC correctly depicted biliary stones in nine of 10 patients and anatomic variations in all five patients, and no false-positive cases were observed. VCTC showed excellent endolumenal visualization of 87 of 99 segments of the biliary tree. The processing time (9.3 +/- 2.1 min) was particularly short. CONCLUSION: VCTC with intravenous infusion of iotroxindimeglumine may be a feasible clinical tool, with acceptable accuracy in selected cases.

Cholangiography↗
PubMedDate not supplied

Mucin-hypersecreting papillary cholangiocarcinoma presenting as abdominal wall abscess: CT and spiral CT cholangiography.

We describe CT findings of a case of mucin-hypersecreting papillary cholangiocarcinoma (MHPC), with extrahepatic bile leakage to the rectus abdominis muscle via the ligamentum teres hepatis forming an abdominal wall abscess. Endoscopic retrograde cholangiography was unsatisfactory. Spiral three-dimensional CT cholangiography was helpful in assessing the resectability of MHPC by offering anatomic details of the uninvolved biliary tree.

Abdominal Abscess↗
PubMed2004

Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis.

To determine the accuracy of computed tomographic intravenous cholangiography (CT-IVC) for detection of choledocholithiasis. Sixty-five patients undergoing endoscopic retrograde cholangiography (ERC) underwent CT-IVC prior to ERC, using a single detector helical CT following intravenous infusion of 100 ml iotroxate. Patients with bilirubin levels >3 times normal were excluded. ERC was indeterminate in three patients (4.7%) and CT-IVC in four (6.3%). Twenty-three patients had ductal calculi at ERC, and CT-IVC was positive in 22, with two false positives and one false negative: sensitivity 95.6%, specificity 94.3%. Stones were multiple in nine and solitary in 14. Of the 14 solitary stones, ten were <or=5 mm and eight were <or=4 mm. The bilirubin level in positive cases was within normal in 20. Maximum intensity projection (MIP) reformats showed stones in only 27% of cases and surface rendered (SR) reformats in none. CT-IVC is highly accurate for detection of ductal calculi, including single small calculi, with a normal or near normal serum bilirubin. Axial images should be used for interpretation rather than MIP or SR reformats.

Bilirubin↗
PubMed2005

The value of drip infusion cholangiography using multidetector-row helical CT in patients with choledocholithiasis.

The purposes of this study were to investigate the feasibility of drip infusion cholangiography computed tomography (CTCh) for choledocholithiasis and to compare the detection of the stone on CTCh with that of MR cholangiopancreatography (MRCP). CTCh examinations were performed after infusion of intravenous biliary contrast material (iotroxic acid meglumine, 100 ml) for patients with suspected biliary diseases and were reconstructed to maximum intensity projection (MIP) and multiplanar reformation (MPR). Of 432 patients who underwent CTCh, we identified 15 who underwent surgery or cholangioscopic removal for choledocholithiasis and 32 patients who underwent cholecystectomy due to cholecystolithiasis. Their MRCP images were compared with the CTCh images. The sensitivity and specificity of CTCh for detecting choledochal stones were 87% and 96% whereas those of MRCP were 80% and 88%. The sensitivity and specificity of CTCh for detecting gallstones were 78% and 100% whereas those of MRCP were 94% and 88%. CTCh allowed high sensitivity and specificity for detecting choledochal stones but diminished the detection for cholecystolithiasis compared with MRCP.

Adult↗