Multi Slice CT Cholangiography Using Minimum Intensity Projection in Evaluation of Patients with Biliary Obstruction: Comparison with Percutaneous Trans Hepatic Cholangiography

Background: Evaluation of the diagnostic value of computed tomography (CT) cholangiography with minimum intensity projection (MinIP) in the work up of patients with obstructive biliary disease through correlation with percutaneous trans hepatic cholangiography (PTC) results. Objective: In this study, we aimed to evaluate the diagnostic value of CT cholangiography with MinIP in the work up of patients with obstructive biliary disease through correlation with PTC results. Patients and Method: The study included 36 patients (26 males and 10 females), with biliary obstruction. CT cholangiography was done to reach a definite diagnosis for the cause of obstruction and PTC was done during their management plan. Analysis of the image data with (MinIP) images was created on a separate workstation and compared to that of PTC. Results: The CT cholangiography using MinIP technique correctly diagnosed the cause of obstruction among all included cases. No significant difference was found between measurements of obstructing lesion size. We had a novel observation about that axial images are significantly better to reveal the obstructing biliary lesion if the cause of obstruction is intrahepatic; while coronal images are significantly better to reveal the obstructing biliary lesion if the cause of obstruction is extrahepatic. Conclusion: CT cholangiography with MinIP is a complete noninvasive technique that provides projectional images similar to that of PTC without administration of oral specific contrast agents, requires no medications, less operator dependent and no complications were encountered in adequately screened patients.