Reevaluation of spiral CT cholangiography: basic considerations and reliability for detecting choledocholithiasis in 80 patients

The purpose of this work was to reevaluate the characteristics and diagnostic accuracy of spiral CT cholangiography (CTC) for detecting biliary calculi.

Spiral CTC was performed in 133 patients with suspected biliary or pancreatic diseases. All source images were reviewed by two radiologists who were unaware of final diagnoses. Attenuation values of bile were correlated with biochemical data and visualization of anatomic detail. The statistical measures in detecting the presence of choledocholithiasis were calculated in 80 patients with confirmed diagnoses.

Statistically significant correlations were found between the degree of biliary enhancement and both serum bilirubin and alkaline phosphatase levels. Of the 80 patients, 18 (23%) had choledocholithiasis and 62 did not. Observers diagnosed them with a sensitivity of 89% and a specificity of 98%. A mild adverse reaction to contrast material was observed in three (2.3%) patients.

Spiral CTC is a reliable, noninvasive, and accessible technique for detecting choledocholithiasis.