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Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis

  • Hepatobiliary-Pancreas
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Abstract

To determine the accuracy of computed tomographic intravenous cholangiography (CT-IVC) for detection of choledocholithiasis. Sixty-five patients undergoing endoscopic retrograde cholangiography (ERC) underwent CT-IVC prior to ERC, using a single detector helical CT following intravenous infusion of 100 ml iotroxate. Patients with bilirubin levels >3 times normal were excluded. ERC was indeterminate in three patients (4.7%) and CT-IVC in four (6.3%). Twenty-three patients had ductal calculi at ERC, and CT-IVC was positive in 22, with two false positives and one false negative: sensitivity 95.6%, specificity 94.3%. Stones were multiple in nine and solitary in 14. Of the 14 solitary stones, ten were ≤5 mm and eight were ≤4 mm. The bilirubin level in positive cases was within normal in 20. Maximum intensity projection (MIP) reformats showed stones in only 27% of cases and surface rendered (SR) reformats in none. CT-IVC is highly accurate for detection of ductal calculi, including single small calculi, with a normal or near normal serum bilirubin. Axial images should be used for interpretation rather than MIP or SR reformats.

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Acknowledgments

Grants supporting this study were received from Royal Australian and New Zealand College of Radiologists; Schering, Berlin, Germany.

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Authors and Affiliations

  1. Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Mebourne, Victoria, 3050, Australia

    Robert N. Gibson & Janette M. Vincent

  2. Department of Gastroenterology, Royal Melbourne Hospital, Mebourne, Victoria, 3050, Australia

    Tony Speer & Keith Noack

  3. Department of Surgery, Royal Melbourne Hospital, Mebourne, Victoria, 3050, Australia

    Neil A. Collier

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  1. Robert N. Gibson
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  2. Janette M. Vincent
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  3. Tony Speer
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  4. Neil A. Collier
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Correspondence to Robert N. Gibson.

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Gibson, R.N., Vincent, J.M., Speer, T. et al. Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis. Eur Radiol 15, 1634–1642 (2005). https://doi.org/10.1007/s00330-004-2606-8

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  • DOI: https://doi.org/10.1007/s00330-004-2606-8

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