Skip to main content
SpringerLink
Log in

Assessment of the optimal temporal window for intravenous CT cholangiography

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The optimal temporal window of intravenous (IV) computed tomography (CT) cholangiography was prospectively determined. Fifteen volunteers (eight women, seven men; mean age, 38 years) underwent dynamic CT cholangiography. Two unenhanced images were acquired at the porta hepatis. Starting 5 min after initiation of IV contrast infusion (20 ml iodipamide meglumine 52%), 15 pairs of images at 5-min intervals were obtained. Attenuation of the extrahepatic bile duct (EBD) and the liver parenchyma was measured. Two readers graded visualization of the higher-order biliary branches. The first biliary opacification in the EBD occurred between 15 and 25 min (mean, 22.3 min ± 3.2) after initiation of the contrast agent. Biliary attenuation plateaued between the 35- and the 75-min time points. Maximum hepatic parenchymal enhancement was 18.5 HU ± 2.7. Twelve subjects demonstrated poor or non-visualization of higher-order biliary branches; three showed good or excellent visualization. Body weight and both biliary attenuation and visualization of the higher-order biliary branches correlated significantly (P<0.05). For peak enhancement of the biliary tree, CT cholangiography should be performed no earlier than 35 min after initiation of IV infusion. For a fixed contrast dose, superior visualization of the biliary system is achieved in subjects with lower body weight.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Masci E, Toti G, Mariani A et al (2001) Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol 96:417–423

    Article  PubMed  CAS  Google Scholar 

  2. Loperfido S, Angelini G, Benedetti G et al (1998) Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study. Gastrointest Endosc 48:1–10

    Article  PubMed  CAS  Google Scholar 

  3. Ward J, Sheridan MB, Guthrie JA et al (2004) Bile duct strictures after hepatobiliary surgery: assessment with MR cholangiography. Radiology 231:101–108

    Article  PubMed  Google Scholar 

  4. Valls C, Alba E, Cruz M et al (2005) Biliary complications after liver transplantation: diagnosis with MR cholangiopancreatography. AJR Am J Roentgenol 184:812–820

    PubMed  Google Scholar 

  5. Vitellas KM, El-Dieb A, Vaswani KK et al (2002) MR cholangiopancreatography in patients with primary sclerosing cholangitis: interobserver variability and comparison with endoscopic retrograde cholangiopancreatography. AJR Am J Roentgenol 179:399–407

    PubMed  CAS  Google Scholar 

  6. Aube C, Delorme B, Yzet T et al (2005) MR cholangiopancreatography versus endoscopic sonography in suspected common bile duct lithiasis: a prospective, comparative study. AJR Am J Roentgenol 184:55–62

    Google Scholar 

  7. Ragozzino A, De Ritis R, Mosca A, Iaccarino V, Imbriaco M (2004) Value of MR cholangiography in patients with iatrogenic bile duct injury after cholecystectomy. AJR Am J Roentgenol 183:1567–1572

    PubMed  Google Scholar 

  8. Eracleous E, Genagritis M, Papanikolaou N et al (2005) Complementary role of helical CT cholangiography to MR cholangiography in the evaluation of biliary function and kinetics. Eur Radiol 15:2130–2139

    Article  PubMed  Google Scholar 

  9. Wang ZJ, Yeh BM, Roberts JP, Breiman RS, Qayyum A, Coakley FV (2005) Living donor candidates for right hepatic lobe transplantation: evaluation at CT cholangiography-initial experience. Radiology 235:899–904

    Article  PubMed  Google Scholar 

  10. Caoili EM, Paulson EK, Heyneman LE, Branch MS, Eubanks WS, Nelson RC (2000) Helical CT cholangiography with three-dimensional volume rendering using an oral biliary contrast agent: feasibility of a novel technique. AJR Am J Roentgenol 174:487–492

    PubMed  CAS  Google Scholar 

  11. Chopra S, Chintapalli KN, Ramakrishna K, Rhim H, Dodd GD 3rd (2000) Helical CT cholangiography with oral cholecystographic contrast material. Radiology 214:596–601

    PubMed  CAS  Google Scholar 

  12. Yeh BM, Breiman RS, Taouli B, Qayyum A, Roberts JP, Coakley FV (2004) Biliary tract depiction in living potential liver donors: comparison of conventional MR, mangafodipir trisodium-enhanced excretory MR, and multi-detector row CT cholangiography-initial experience. Radiology 230:645–651

    Article  PubMed  Google Scholar 

  13. Okada M, Fukada J, Toya K, Ito R, Ohashi T, Yorozu A (2005) The value of drip infusion cholangiography using multidetector-row helical CT in patients with choledocholithiasis. Eur Radiol 15:2140–2145

    Article  PubMed  Google Scholar 

  14. Gibson RN, Vincent JM, Speer T, Collier NA, Noack K (2005) Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis. Eur Radiol 15:1634–1642

    Article  PubMed  Google Scholar 

  15. Persson A, Dahlstrom N, Smedby O, Brismar TB (2005) Volume rendering of three-dimensional drip infusion CT cholangiography in patients with suspected obstructive biliary disease: a retrospective study. Br J Radiol 78:1078–1085

    Article  PubMed  CAS  Google Scholar 

  16. Schroeder T, Malago M, Debatin JF et al (2002) Multidetector computed tomographic cholangiography in the evaluation of potential living liver donors. Transplantation 73:1972–1973

    Article  PubMed  Google Scholar 

  17. Burgener FA (1980) Intravenous cholangiography: experimental evaluation of the time-density-retention concept. AJR Am J Roentgenol 134:665–667

    PubMed  CAS  Google Scholar 

  18. Moss AA, Nelson J, Amberg J (1973) Intravenous cholangiography. An experimental evaluation of several currently proposed methods. Am J Roentgenol Radium Ther Nucl Med 117:406–411

    PubMed  CAS  Google Scholar 

  19. Moss AA (1977) Double-blind comparison of iodipamide and lodoxamate using direct and drip infusion intravenous cholangiography. AJR Am J Roentgenol 128:931–933

    PubMed  CAS  Google Scholar 

  20. Robbins AH, Sargent EN, Vincent ME, Boswell W, Meyers HI (1976) Double-blind comparison of meglumine lodoxamate (Cholovue) and meglumine iodipamide (Cholografin). AJR Am J Roentgenol 127:257–260

    PubMed  CAS  Google Scholar 

  21. Scholz FJ, Johnston DO, Wise RE (1975) Intravenous cholangiography: optimum dosage and methodology. Radiology 114:513–518

    PubMed  CAS  Google Scholar 

  22. Loeb PM, Berk RN, Cobo-Frenkel A, Barnhart JL (1976) The biliary and urinary excretion and the choleretic effect of ioglycamide in dogs. Invest Radiol 11:449–458

    Article  PubMed  CAS  Google Scholar 

  23. Stockberger SM, Wass JL, Sherman S, Lehman GA, Kopecky KK (1994) Intravenous cholangiography with helical CT: comparison with endoscopic retrograde cholangiography. Radiology 192:675–680

    PubMed  CAS  Google Scholar 

  24. Bracco Diagnostics Instruction Sheet. Cholografin® Meglumine, Iodipamide Meglumine Injection USP 52%. Bracco Diagnostics Inc, Princeton, NJ 08543, revised July 2000

  25. Vauthey JN, Abdalla EK, Doherty DA et al (2002) Body surface area and body weight predict total liver volume in Western adults. Liver Transpl 8:233–240

    Article  PubMed  Google Scholar 

  26. Chan SC, Liu CL, Lo CM et al (2006) Estimating liver weight of adults by body weight and gender. World J Gastroenterol 12:2217–2222

    PubMed  Google Scholar 

  27. Nawaratne S, Brien JE, Seeman E et al (1998) Relationships among liver and kidney volumes, lean body mass and drug clearance. Br J Clin Pharmacol 46:447–452

    Article  PubMed  CAS  Google Scholar 

  28. Wallers KJ, McDermott P, James WB (1981) Intravenous cholangiography by bolus injection of meglumine iotroxamate and meglumine iodoxamate: a comparative trial of two new contrast media. Clin Radiol 32:457–459

    Article  PubMed  CAS  Google Scholar 

  29. Takahashi M, Saida Y, Itai Y, Gunji N, Orii K, Watanabe Y (2000) Reevaluation of spiral CT cholangiography: basic considerations and reliability for detecting choledocholithiasis in 80 patients. J Comput Assist Tomogr 24:859–865

    Article  PubMed  CAS  Google Scholar 

  30. Fleischmann D, Ringl H, Schofl R et al (1996) Three-dimensional spiral CT cholangiography in patients with suspected obstructive biliary disease: comparison with endoscopic retrograde cholangiography. Radiology 198:861–868

    PubMed  CAS  Google Scholar 

  31. Miller GA, Yeh BM, Breiman RS, Roberts JP, Qayyum A, Coakley FV (2004) Use of CT cholangiography to evaluate the biliary tract after liver transplantation: initial experience. Liver Transpl 10:1065–1070

    Article  PubMed  Google Scholar 

  32. Nilsson U (1987) Adverse reactions to iotroxate at intravenous cholangiography. A prospective clinical investigation and review of the literature. Acta Radiol 28:571–575

    Article  PubMed  CAS  Google Scholar 

  33. Lindsey I, Nottle PD, Sacharias N (1997) Preoperative screening for common bile duct stones with infusion cholangiography: review of 1,000 patients. Ann Surg 226:174–178

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

The authors are grateful to Richard Youngblood, MA, Associate in Research, for reviewing the manuscript.

Author information

Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, P.O. Box 3808, Erwin Road, Durham, NC, 27710, USA

    Sebastian T. Schindera, Rendon C. Nelson, Erik K. Paulson, David M. DeLong & Elmar M. Merkle

Authors
  1. Sebastian T. Schindera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rendon C. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erik K. Paulson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David M. DeLong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elmar M. Merkle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sebastian T. Schindera.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schindera, S.T., Nelson, R.C., Paulson, E.K. et al. Assessment of the optimal temporal window for intravenous CT cholangiography. Eur Radiol 17, 2531–2537 (2007). https://doi.org/10.1007/s00330-007-0709-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-007-0709-8

Keywords

Search

Navigation