MR AND CT CHOLANGIOGRAPHY IN EVALUATION OF THE BILIARY-TRACT

Objective: To compare MR and CT cholangiography (MRC and CTC) in evalu ating the anatomy of the extrahepatic biliary tract and the pathology related to the gallbladder. Material and Methods: Twenty-three patient s underwent MRC and CTC with a biliary contrast medium for investigati on of biliary disease. 3D displays of both were also obtained. Endosco pic retrograde cholangiography was performed in 17 patients, and the p athology of all 23 was evaluated. Results. Overall, the image quality was higher with CTC than with MRC (4.7 vs 3.9, p < 0.05). The cystic d uct was demonstrated better by CTC than MRC (p < 0.05). Multiplanar re formation (MPR) and source images provided additional information to t hat obtained from 3D MRC and CTC images. Gallstones were revealed in 6 patients by CTC and in 5 of these 6 by MRC. In 2 patients with cholec ystitis, CTC demonstrated gallbladder wall thickening but MRC did not. In 3 patients with adenomyomatosis, MRC demonstrated Rokitansky-Ascho ff sinuses (RAS) while CTC demonstrated focal gallbladder wall thicken ing in all 3 and RAS in 1 of them. Conclusion: Both MRC and CTC provid ed anatomical and pathological information about the biliary system. W ith both techniques, however, either MPR or source images proved neces sary in addition for evaluating the biliary system anatomy and patholo gy. The gallbladder wall was depicted clearly in source CTC, but MRC i s recommended for the evaluation of adenomyomatosis because it depicts RAS clearly.