Multidetector CT of Emergent Biliary Pathologic Conditions (original) (raw)
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Role Ultrasonography Diagnosis Biliary Tract Diseases
Background: The development of new diagnostic imaging techniques has not eliminated the challenge of diagnosing right upper quadrant pain in some patients. This challenge persists for both clinicians and radiologists. To study the role of ultrasonography in diagnosing biliary tract diseases. Methods: This study included patients suspected of having biliary tract diseases who were admitted to the surgical wards of Shri Jagannath Medical College and Hospital, Puri, between August 2021 and July 2023. Results: Among the 104 patients in this study, 36 (34.6%) were diagnosed with acute cholecystitis through surgery and pathological examination. Ultrasonography identified acute cholecystitis in 44 patients. Of these, there were 34 true-positive diagnoses, 10 false-positive diagnoses (8 interpreted as chronic cholecystitis and 2 others), and 2 false-negative diagnoses. Maximal focal tenderness was located over the gallbladder fossa in 34 of the 36 patients with surgically and pathologically confirmed acute cholecystitis. Conclusion: Due to its advantages of being inexpensive, non-invasive, and time-saving (particularly for critically ill patients), along with its high sensitivity, specificity, and accuracy, ultrasound has become the primary modality for investigating and managing biliary tract diseases.
Role of Ultrasonography in Diagnosis of Biliary Tract Diseases: A Single Centre Experience
SSR Institute of International Journal of Life Sciences, 2024
Background: The development of new diagnostic imaging techniques has not eliminated the challenge of diagnosing right upper quadrant pain in some patients. This challenge persists for both clinicians and radiologists. To study the role of ultrasonography in diagnosing biliary tract diseases. Methods: This study included patients suspected of having biliary tract diseases who were admitted to the surgical wards of Shri Jagannath Medical College and Hospital, Puri, between August 2021 and July 2023. Results: Among the 104 patients in this study, 36 (34.6%) were diagnosed with acute cholecystitis through surgery and pathological examination. Ultrasonography identified acute cholecystitis in 44 patients. Of these, there were 34 true-positive diagnoses, 10 false-positive diagnoses (8 interpreted as chronic cholecystitis and 2 others), and 2 false-negative diagnoses. Maximal focal tenderness was located over the gallbladder fossa in 34 of the 36 patients with surgically and pathologically confirmed acute cholecystitis. Conclusion: Due to its advantages of being inexpensive, non-invasive, and time-saving (particularly for critically ill patients), along with its high sensitivity, specificity, and accuracy, ultrasound has become the primary modality for investigating and managing biliary tract diseases.
Role of MultiDetector Computed Tomography in Biliary Obstruction
Zagazig University Medical Journal
Background: Obstructive Jaundice is a common surgical problem, MultiDetector Computed Tomography in diagnosis of biliary tract obstruction has a vital role as post processing techniques can be utilized to identify variant biliary anatomy to guide preoperative biliary surgery planning, determine level and cause of obstruction, early tumor detection and staging of biliary cancer are the key factors for possible cure by surgical resection, our aim is to evaluate the role of MDCT in diagnosing level and cause of biliary obstruction. Patients and Methods: Sixty nine patients with clinically suspected biliary obstruction were encountered in the study and subjected to clinical assessment including full history taking, clinical examination and imaging assessment by MDCT, our findings were correlated to standard reference examinations including: Operative/ERCP/Biopsy and histopathology findings. Results: Our results showed that the most affected age group was group between 60: <70 years old, males were affected more than females. The most common clinical presentation in our patients was yellowish discoloration of the skin and sclera followed by biliary colic. Right hypochondrial tenderness was the main clinical finding on clinical examination in our study. Our patients were categorized according to the cause of biliary obstruction into seven groups: Malignant stricture group 52.2% (36patients), Calcular group 24.6% (17patients), Iatrogenic group 5.8% (4patients), Porta hepatis lesions group 5.8% (4patients), Benign stricture group 4.3% (3patients), Inflammatory group 4.3% (3patients), Congenital group 1.4% (1patient). Conclusions: MultiDetector computed tomography provides a modality with high diagnostic performance for differentiating benign from malignant lesions and in detecting biliary calculi.
Comparison of Ultrasonography and Computed Tomography to Evaluate the Causes of Biliary Obstruction
Euroasian Journal of Hepato-Gastroenterology, 2012
Objective: To observe the role of computed tomographic (CT) scan and ultrasonography (USG) examination to evaluate the causes of biliary obstruction. Materials and methods: This cross-sectional study was conducted in a total of 57 patients clinically suspected of obstructive jaundice. Results: The highest incidence of biliary obstruction was found in the age group between 40 and 49 years and the mean (±SE) age of the patients was 48.4 ± 1.6 years. Serum bilirubin and serum alkaline phosphatase were high in all patients. For evaluation of pancreatic mass, USG found true positive in 13 with no false positive, false negative 2 and true negative 42 cases. Similarly, CT scan found true positive in 15 and no false positive, no false negative and true negative in 42 cases. Sensitivity and specificity of USG in detecting pancreatic mass were 80 and 97.6%. CT scan showed 93.3% sensitivity and 97.6% specificity. In case of gallbladder (GB) mass USG found true positive in 20 and 1 false positive. There was no false negative and true negative in 36 cases. CT scan also revealed better sensitivity. USG could not detect any case of periampulla. Conclusion: Accuracy of USG and CT is high in detecting biliary tree dilatation, with CT scan slightly more accurate than USG. The difference in cost between the two is likely to decline with time and make CT even more attractive and handy for imaging the hepatobiliary system.
Medical ultrasonography, 2015
Ultrasonography is generally accepted and performed as a first choice imaging technique in patients with jaundice. The method allows the discrimination between cholestatic and mechanical jaundice. The existing procedures are multiple: gray scale, Doppler, i.v. contrast enhancement, elastography, tridimensional ultrasonography, each of these with different contribution to the positive and differential diagnosis regarding the nature of the jaundice. The final diagnosis is a multimodal one and the efficiency is dependent on the level of the available technology, the examiner's experience, the degree and modality of integration of the data within the clinical context, as well as on the portfolio of available imaging procedures. This review shows the main ultrasonographic methods consecrated in the evaluation of the biliary tree. It also underlines the integrated character of the procedures, as well as the necessity to correlate with other imaging methods and the clinical situation.
PubMed, 2010
Objective: To evaluate accuracy of multidetector computed tomography (MDCT) cholangiography in evaluation of cause of biliary tract obstruction. Material and method: MDCT cholangiographs of 50 patients with clinically suspected biliary tract obstruction were retrospectively reconstructed and reviewed. The causes of obstruction identified by MDCT were divided into three groups including calculus, benign stricture, and malignancy. Final diagnosis was based on pathological diagnosis or endoscopic retrograde cholangiopancreatography or follow-up. The MDCT diagnosis and final diagnosis were compared Results: The sensitivity, specificity, positive predictive value, and negative redictive value of MDCT cholangiography for detection of calculus, benign stricture, and malignancy were 91.7-100%, except for sensitivity and positive predictive value for detection of benign stricture, which were 66.7% and 66.7% respectively. Conclusion: MDCT cholangiography is a fast, noninvasive technique that offers high diagnostic accuracy in evaluation of cause of biliary tract obstruction.
Role of99mTc-IDA cholescintigraphy in evaluating biliary tract disorders
Gastrointestinal Radiology, 1980
Technetium-99m IDA cholescintigraphy has provided a new, noninvasive means of visualizing biliary tract function. It has become the procedure of choice in patients with suspected acute cholecystitis because of its ability to most accurately detect functional obstruction or patency of the cystic duct as opposed to ultrasound's ability to detect only anatomic changes such as the presence of calculi or a thickened gallbladder wall. These latter findings are more important in establishing the diagnosis of chronic cholecystitis where ultrasound shares a position of prime importance with the oral cholecystogram. Tc-99m IDA cholescintigraphy has also been particularly useful in evaluating bile leaks, biliary-enteric anastomosis patency and the post-cholecystectomy patient with recurrent pain. In the patient with cholestasis, ultrasound is usually the procedure of choice since it establishes whether or not ductal dilatation is present and frequently can determine the cause of obstruction. Cholescintigraphy has played an ancillary role in many cases by demonstrating the level of partial obstruction, but it does not have the anatomic resolution to visualize the cause of obstruction. Occasionally, in the evaluation of cholestasis, cholescintigraphy has proven to be the only modality which has identified the presence of acute common duct obstruction or localized intrahepatic ductal obstruction. All in all, Tc-99m IDA cholescintigraphy has had a dramatic impact upon hepatobiliary diagnosis.