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MDCT Cholangiography with Volume Rendering for the Assessment of Patients with Biliary Obstruction

Ali Ahmetoglu1, Polat Kosucu1, Sibel Kul1, Hasan Dinç1, Ahmet Sari1, Mehmet Arslan2, Etem Alhan3 and Halit Resit Gümele1

1 Department of Radiology, Karadeniz Technical University, Faculty of Medicine, Trabzon 61080, Turkey.
2 Department of Gastroenterology and Hepatology, Karadeniz Technical University, Faculty of Medicine, Trabzon 61080, Turkey.
3 Department of Surgery, Karadeniz Technical University, Faculty of Medicine, Trabzon 61080, Turkey.



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Fig. 1. 48-year-old man with biliary obstruction. MDCT cholangiographic image shows dilatation of common bile duct and oval hypodense filling defect (arrow) surrounded by hyperdense bile in distal common bile duct, suggesting presence of biliary stone.

 


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Fig. 2A. 58-year-old man with biliary obstruction. MDCT cholangiographic image shows smooth narrowing in short segment of distal common bile duct (short arrows), suggesting benign stricture. Patient also had hypodense stone (long arrow) proximal to stricture.

 


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Fig. 2B. 58-year-old man with biliary obstruction. ERCP image shows common bile duct stricture and stone (arrow).

 


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Fig. 3. 64-year-old man with malignant biliary obstruction secondary to cholangiocarcinoma. MDCT cholangiographic image shows common bile duct obstruction with shoulder appearance (arrows) and dilatation in common bile duct and intrahepatic bile ducts.

 


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Fig. 4A. 39-year-old man with elevated bilirubin level. 7.07 mm indicates diameter of common bile duct. Double arrows indicate duodenum. MDCT cholangiographic image shows hypodense filling defect (single arrow) in common bile duct, suggesting presence of biliary stone.

 


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Fig. 4B. 39-year-old man with elevated bilirubin level. 7.07 mm indicates diameter of common bile duct. Double arrows indicate duodenum. MDCT angiographic image derived from same MDCT data as A without changing position of clip planes or arrows shows that hypodense filling defect seen on MDCT cholangiography was due to gastroduodenal artery (single arrow) superimposed on common bile duct.

 


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Fig. 5A. 56-year-old woman with biliary obstruction secondary to tumor in pancreatic head. MDCT cholangiographic image shows abrupt narrowing (arrow) and dilatation in common bile duct. Patient also had dilatation in intrahepatic bile ducts and gallbladder.

 


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Fig. 5B. 56-year-old woman with biliary obstruction secondary to tumor in pancreatic head. MDCT venographic image shows narrowing of portal vein caused by invasion of tumor.

 

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