Abstract:
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Purpose: To evaluate the usefulness of MDCT, multiplanar reformatted images for noninvasive assessment of stent patency and planning for management in the patients with self-expandable metallic stent due to malignant biliary obstruction.
Methods and Materials: Among consecutive 87 patients( 12 men and 8 women ; mean age, 66.2 years ) with malignant biliary obstruction who underwent self-expandable metallic stent insertion in biliary system from August 1999 to Mars 2003, 32 patients were evaluated with MDCT for suspicion of stent dysfunction. 23 cases in 20 patients of them also underwent percutaneous transhepatic biliary drainage within 7 days after MDCT were enrolled in this study. All MDCT images were reconstruted with multiplanar reformatted images and reviewed by 2 radiologists who had no knowledge of the cholangiographic results. By using direct cholangiography as the standard of reference, the usefulness of MDCT in assessing the patency of stent and the extent of tumor was determined.
Results: MDCT correctly demonstrated the severe or complete occlusion of stent in all 23 cases in 20 patients. It was adequate in helping depict the precise location of stent occlusion in 20 cases (87%) and led to underestimation in 2 cases (8.7%), and overestimation in 1 case (4.3%), respectively. MDCT also revealed the extent of tumor that represented as the enhancing intraluminal mass or wall thickening around stent and provided the information about the possible cause of occlusion.
Conclusion: MDCT is a useful imaging modality for noninvasive assessement of stent patency when stent occlusion is suspected. MDCT can also provide more informations about distal portion of occlusion site such as the extent of tumor and the cause of occlusion that cannot be evaluated in direct cholangiography and allows adequate planning for management.
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Kim MD, S,
Biliary Stent Patency: Assessment with Multi-detector Row CT (MDCT) and Multiplanar Reformatted Images. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3105968.html
