Computed tomographic cholangiography using spiral scanning and 3D image processing.

Volumetric computed tomography (CT) scans ("spiral CT") were performed after intravenous (i.v.) cholangiography followed by additional 3D surface reconstructions of gallbladder and biliary ducts. 34 patients were investigated prior to cholecystectomy. No allergic adverse reactions were observed. The scan time was 24 s. Contrast enhancement in the extrahepatic bile duct and gallbladder were measured. All CT image series were reviewed independently by four experienced physicians (two radiologists, two surgeons) and compared for quality with conventional cholangiography on a three-point scale. The average rating for the demonstration of the biliary tract was significantly better for spiral CT than for conventional cholangiography (p < 0.01). In all cases sufficient contrast was found in the common bile duct (mean 315 HU). 3D imaging was considered to be helpful for intraoperative orientation during laparoscopic surgery.