MDCT Cholangiography with Volume Rendering for the Assessment of Patients with Biliary Obstruction
Ali Ahmeto
lu1,
Polat Ko
ucu1,
Sibel Kul1,
Hasan Dinç1,
Ahmet Sari1,
Mehmet Arslan2,
Etem Alhan3 and
Halit Re
it 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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Copyright © 2004 by the American Roentgen Ray Society.