Three-dimensional spiral CT cholangiography in patients with suspected obstructive biliary disease: comparison with endoscopic retrograde cholangiography.

PURPOSE To evaluate the diagnostic potential of spiral computed tomography (CT) performed after the administration of cholangiographic contrast material (spiral CT cholangiography) in patients with suspected obstructive biliary disease. MATERIALS AND METHODS After infusion of meglumine iodoxamate, 29 patients underwent upper abdominal spiral CT with subsequent three-dimensional rendering of the biliary tract. In 27 patients, the presence, site, and extent of biliary obstruction were compared with that at endoscopic retrograde cholangiography (ERC). RESULTS Spiral CT cholangiography correctly depicted biliary obstruction in 14 of 27 patients, with no false-positive or false-negative cases. In one patient, the precise length of a common bile duct stenosis could not be assessed with spiral CT cholangiography. ERC demonstrated intrahepatic ductal stenoses more clearly in two patients. In two patients with hilar cholangiocarcinomas, spiral CT cholangiography depicted undrained areas not seen with ERC. CONCLUSION Spiral CT cholangiography allows accurate assessment of the biliary system in patients with suspected obstructive biliary disease.