Cholangiographically-enhanced CT of the pancreas and biliary tree

Cholangiographically-enhanced CT scans were performed on nine patients with biliary obstruction or suspected pancreatic masses. The opacification of the biliary tree was obtained by slow infusion of 25 ml of cholangiographic contrast medium diluted in 75 ml of saline and administered 45 mins before the CT examination. Two separate CT sequences were obtained, one with cholangiographic contrast alone, the other with associated parenchymal enhancement. The tolerability of the overall procedure was very good. The measurement of the HU values of the biliary ducts showed a marked increase in bile density. These structures could easily be appreciated within the liver and in the porta hepatis; the pancreatic head and its relationships with the main bile duct were evident. The densitometric measurement of the liver parenchyma before and after contrast enhancement did not show any variation with respect to the standard HU values. Cholangiographically-enhanced CT proved to be useful for the diagnosis of biliary obstruction; it may also be a promising diagnostic tool for the evaluation of pancreatic masses.