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Helical CT Cholangiography with Three-Dimensional Volume Rendering Using an Oral Biliary Contrast Agent

Feasibility of a Novel Technique

Elaine M. Caoili1, Erik K. Paulson1, Laura E. Heyneman1, M. Stanley Branch2, W. Steve Eubanks3 and Rendon C. Nelson1

1 Department of Radiology, Box 3808, Duke University Medical Center, Durham, NC 27710.
2 Department of Medicine, Duke University Medical Center, Durham, NC 27710.
3 Department of Surgery, Duke University Medical Center, Durham, NC 27710.



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  		Fig. 1. —32-year-old healthy male volunteer. Three-dimensional volume-rendered CT cholangiogram shows low cystic duct (arrows) insertion. Image is in left posterior oblique orientation.

 


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  		Fig. 2. —42-year-old healthy female volunteer. Lateral projection of three-dimensional volume-rendered CT cholangiogram shows posterior cystic duct insertion (arrow). A=anterior.

 


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  		Fig. 3A. —48-year-old woman with symptomatic cholelithiasis. Three-dimensional volume-rendered CT cholangiogram shows helical or left cystic duct insertion (arrows). Cystic duct courses posteriorly before joining left side of common hepatic duct.

 


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  		Fig. 3B. —48-year-old woman with symptomatic cholelithiasis. Three-dimensional volume-rendered CT cholangiogram reveals gallstones.

 


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  		Fig. 4. —48-year-old woman with symptomatic cholelithiasis. Source image shows varices (arrows) at gallbladder neck and dependent gallstones.

 


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  		Fig. 5. —36-year-old healthy male volunteer. Three-dimensional volume-rendered CT cholangiogram shows pseudostrictures (arrows) involving common hepatic and common bile ducts. Pseudostrictures are probably caused by underdistention or incomplete opacification of bile ducts.

 


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  		Fig. 6. —48-year-old woman with symptomatic cholelithiasis. Three-dimensional volume-rendered CT cholangiogram shows segmentation of biliary tract and gallbladder; segmented appearance results from respiratory motion. Irregular appearance of gallbladder fundus is caused by motion artifacts. Gallstones cannot be seen on this image.

 

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