Spiral computed tomography-intravenous cholangiography with three-dimensional reconstructions for imaging the biliary tree

This study aimed to assess the ability of CT-i.v. cholangiography to show the perihilar biliary and cystic duct anatomy and to assess the relative performance of axial, maximum intensity projection and surface rendered displays. We also assessed the correlation between serum bilirubin levels and adequacy of biliary opacification. Spiral CT was carried out following infusion of 100 mL of Biliscopin in 181 patients with suspected biliary disease. The display of biliary anatomy was of high quality, with 91% of patients having good opacification of at least first-order bile ducts and 84% having good opacification of at least third-order right and left hepatic ducts. The quality of biliary opacification correlated inversely to serum bilirubin levels, with levels above two to three times the normal value being associated with lower rates of good opacification. Maximum intensity projection and surface rendered reformats aided anatomical interpretation to a similar degree. The relative frequency of types of perihilar branching patterns and cystic duct junctional anatomy correlated closely to those reported from previous anatomical studies. Copyright (2006) Blackwell Science Pty Ltd