European Radiology

, Volume 15, Issue 8, pp 1634–1642 | Cite as

Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis

  • Robert N. GibsonEmail author
  • Janette M. Vincent
  • Tony Speer
  • Neil A. Collier
  • Keith Noack


To determine the accuracy of computed tomographic intravenous cholangiography (CT-IVC) for detection of choledocholithiasis. Sixty-five patients undergoing endoscopic retrograde cholangiography (ERC) underwent CT-IVC prior to ERC, using a single detector helical CT following intravenous infusion of 100 ml iotroxate. Patients with bilirubin levels >3 times normal were excluded. ERC was indeterminate in three patients (4.7%) and CT-IVC in four (6.3%). Twenty-three patients had ductal calculi at ERC, and CT-IVC was positive in 22, with two false positives and one false negative: sensitivity 95.6%, specificity 94.3%. Stones were multiple in nine and solitary in 14. Of the 14 solitary stones, ten were ≤5 mm and eight were ≤4 mm. The bilirubin level in positive cases was within normal in 20. Maximum intensity projection (MIP) reformats showed stones in only 27% of cases and surface rendered (SR) reformats in none. CT-IVC is highly accurate for detection of ductal calculi, including single small calculi, with a normal or near normal serum bilirubin. Axial images should be used for interpretation rather than MIP or SR reformats.


Computed tomography Bile ducts Intravenous cholangiography Choledocholithiasis 



Grants supporting this study were received from Royal Australian and New Zealand College of Radiologists; Schering, Berlin, Germany.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Robert N. Gibson
    • 1
    Email author
  • Janette M. Vincent
    • 1
  • Tony Speer
    • 2
  • Neil A. Collier
    • 3
  • Keith Noack
    • 2
  1. 1.Department of Radiology, Royal Melbourne HospitalUniversity of MelbourneMebourneAustralia
  2. 2.Department of GastroenterologyRoyal Melbourne HospitalMebourneAustralia
  3. 3.Department of SurgeryRoyal Melbourne HospitalMebourneAustralia

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