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Erschienen in: Abdominal Radiology 3/2005

01.06.2005 | Invited Review

Malignant biliary obstruction: value of imaging findings

verfasst von: C. Stroszczynski, M. Hunerbein

Erschienen in: Abdominal Radiology | Ausgabe 3/2005

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Abstract

This review focuses on the clinical impact of different modalities to image primary and secondary malignant biliary obstruction. The detection and staging of cancers of the pancreatic and biliary tract are best accomplished with endoscopic ultrasound, contrast-enhanced computed tomography, and magnetic resonance cholangiopancreatography. Three-dimensional ultrasound is a new noninvasive method that may be used increasingly as an initial test to select patients who require further diagnostic evaluation by magnetic resonance cholangiopancreatography or therapeutic endoscopic retrograde cholangiopancreatography. All-in-one computed tomography including three-dimensional reconstructions of the biliary tree may be competitive against all-in-one magnetic resonance imaging for diagnosis and staging of pancreatic tumors. Magnetic resonance cholangiopancreatography is excellent for identifying the presence and the level of biliary obstruction. With newer diagnostic imaging technologies emerging, endoscopic retrograde cholangiopancreatography is evolving into a predominantly therapeutic procedure.
Literatur
1.
Zurück zum Zitat Cooperberg, PL, Burhenne, HJ 1980Real-time ultrasonography diagnostic technique of choice in gall-bladder diseaseN Engl J Med.30212771279PubMed Cooperberg, PL, Burhenne, HJ 1980Real-time ultrasonography diagnostic technique of choice in gall-bladder diseaseN Engl J Med.30212771279PubMed
2.
Zurück zum Zitat Blackbourne, L, Earnhardt, RC, Sistrom, CL, et al. 1994The sensitivity and role of ultrasound in the evaluation of biliary obstructionAm Surg.60685690 Blackbourne, L, Earnhardt, RC, Sistrom, CL,  et al. 1994The sensitivity and role of ultrasound in the evaluation of biliary obstructionAm Surg.60685690
3.
Zurück zum Zitat Rickes, S, Unkrodt, K, Neye, H, et al. 2002Differentiation of pancreatic tumors by conventional ultrasound. unenhanced and echo-enhanced power Doppler sonographyScand J Gastroenterol3713131320CrossRefPubMed Rickes, S, Unkrodt, K, Neye, H,  et al. 2002Differentiation of pancreatic tumors by conventional ultrasound. unenhanced and echo-enhanced power Doppler sonographyScand J Gastroenterol3713131320CrossRefPubMed
4.
Zurück zum Zitat Kaneko, T, Kimata, H, Sugimoto, H, et al. 2002Power Doppler ultrasonography for the assessment of vascular invasion by pancreatic cancerPancreatology26168CrossRefPubMed Kaneko, T, Kimata, H, Sugimoto, H,  et al. 2002Power Doppler ultrasonography for the assessment of vascular invasion by pancreatic cancerPancreatology26168CrossRefPubMed
5.
Zurück zum Zitat Songur, Y, Temucin, G, Sahin, B 2001Endoscopic ultrasonography in the evaluation of dilated common bile ductJ Clin Gastroenterol33302305CrossRefPubMed Songur, Y, Temucin, G, Sahin, B 2001Endoscopic ultrasonography in the evaluation of dilated common bile ductJ Clin Gastroenterol33302305CrossRefPubMed
6.
Zurück zum Zitat Linghu, EO, Cheng, LF, Wang, XD, et al. 2004Intraductal ultrasonography and endoscopic retrograde cholangiography in diagnosis of extrahepatic bile duct stones: a comparative studyHepatobiliary Pancreat Dis Int.3129132PubMed Linghu, EO, Cheng, LF, Wang, XD,  et al. 2004Intraductal ultrasonography and endoscopic retrograde cholangiography in diagnosis of extrahepatic bile duct stones: a comparative studyHepatobiliary Pancreat Dis Int.3129132PubMed
7.
Zurück zum Zitat Catanzaro, A, Pfau, P, Isenberg, GA, et al. 2003Clinical utility of intraductal US for evaluation of choledocholithiasisGastrointest Endosc.57648652CrossRefPubMed Catanzaro, A, Pfau, P, Isenberg, GA,  et al. 2003Clinical utility of intraductal US for evaluation of choledocholithiasisGastrointest Endosc.57648652CrossRefPubMed
8.
Zurück zum Zitat Tamada, K, Yasuda, Y, Nagai, H, et al. 2000Limitations of three-dimensional intraductal ultrasonography in the assessment of longitudinal spread of extrahepatic bile duct carcinomaJ Gastroenterol35919923CrossRefPubMed Tamada, K, Yasuda, Y, Nagai, H,  et al. 2000Limitations of three-dimensional intraductal ultrasonography in the assessment of longitudinal spread of extrahepatic bile duct carcinomaJ Gastroenterol35919923CrossRefPubMed
9.
Zurück zum Zitat Hunerbein, M, Stroszczynski, C, Felix, R, et al. 2002Three-dimensional ultrasound cholangiography: a new noninvasive technique for evaluation of biliary obstructionAm J Gastroenterol97500501CrossRefPubMed Hunerbein, M, Stroszczynski, C, Felix, R,  et al. 2002Three-dimensional ultrasound cholangiography: a new noninvasive technique for evaluation of biliary obstructionAm J Gastroenterol97500501CrossRefPubMed
10.
Zurück zum Zitat Hunerbein, M, Stroszczynski, C, Ulmer, C, et al. 2003Prospective comparison of transcutaneous 3-dimensional US cholangiography, magnetic resonance cholangiography, and direct cholangiography in the evaluation of malignant biliary obstructionGastrointest Endosc.58853858CrossRefPubMed Hunerbein, M, Stroszczynski, C, Ulmer, C,  et al. 2003Prospective comparison of transcutaneous 3-dimensional US cholangiography, magnetic resonance cholangiography, and direct cholangiography in the evaluation of malignant biliary obstructionGastrointest Endosc.58853858CrossRefPubMed
11.
Zurück zum Zitat Yeh, BM, Breiman, RS, Taouli, B, et al. 2004Biliary tract depiction in living potential liver donors: comparison of conventional MR, mangafodipir trisodium-enhanced excretory MR, and multi-detector row CT cholangiography-initial experienceRadiology230645651PubMed Yeh, BM, Breiman, RS, Taouli, B,  et al. 2004Biliary tract depiction in living potential liver donors: comparison of conventional MR, mangafodipir trisodium-enhanced excretory MR, and multi-detector row CT cholangiography-initial experienceRadiology230645651PubMed
12.
Zurück zum Zitat Maniatis, P, Triantopoulou, C, Sofianou, E, et al. 2003Virtual CT cholangiography in patients with choledocholithiasisAbdom Imaging28536544CrossRefPubMed Maniatis, P, Triantopoulou, C, Sofianou, E,  et al. 2003Virtual CT cholangiography in patients with choledocholithiasisAbdom Imaging28536544CrossRefPubMed
13.
Zurück zum Zitat Caoili, EM, Paulson, EK, Heyneman, LE, et al. 2000Helical CT cholangiography with three-dimensional volume rendering using an oral biliary contrast agent: feasibility of a novel techniqueAJR174487492PubMed Caoili, EM, Paulson, EK, Heyneman, LE,  et al. 2000Helical CT cholangiography with three-dimensional volume rendering using an oral biliary contrast agent: feasibility of a novel techniqueAJR174487492PubMed
14.
Zurück zum Zitat Takamatsu, S, Goseki, N, Nakajima, K, et al. 2004Distributing pattern of the bile duct of the caudate lobe on computed tomography with drip infusion cholangiography and its surgical significanceHepatogastroenterology512932PubMed Takamatsu, S, Goseki, N, Nakajima, K,  et al. 2004Distributing pattern of the bile duct of the caudate lobe on computed tomography with drip infusion cholangiography and its surgical significanceHepatogastroenterology512932PubMed
15.
Zurück zum Zitat Schroeder, T, Nadalin, S, Stattaus, J, et al. 2002Potential living liver donors: evaluation with an all-in-one protocol with multi-detector row CTRadiology224586591PubMed Schroeder, T, Nadalin, S, Stattaus, J,  et al. 2002Potential living liver donors: evaluation with an all-in-one protocol with multi-detector row CTRadiology224586591PubMed
16.
Zurück zum Zitat Koito, K, Namieno, T, Hirokawa, N, et al. 2001Virtual CT cholangioscopy: comparison with fiberoptic cholangioscopyEndoscopy33676681CrossRefPubMed Koito, K, Namieno, T, Hirokawa, N,  et al. 2001Virtual CT cholangioscopy: comparison with fiberoptic cholangioscopyEndoscopy33676681CrossRefPubMed
17.
Zurück zum Zitat Park, SJ, Han, JK, Kim, TK, et al. 2001Three-dimensional spiral CT cholangiography with minimum intensity projection in patients with suspected obstructive biliary disease: comparison with percutaneous transhepatic cholangiographyAbdom Imaging26281286CrossRefPubMed Park, SJ, Han, JK, Kim, TK,  et al. 2001Three-dimensional spiral CT cholangiography with minimum intensity projection in patients with suspected obstructive biliary disease: comparison with percutaneous transhepatic cholangiographyAbdom Imaging26281286CrossRefPubMed
18.
Zurück zum Zitat David, V, Reinhold, C, Hochman, M, et al. 1998Pitfalls in the interpretation of MR cholangiopancreatographyAJR17010551059PubMed David, V, Reinhold, C, Hochman, M,  et al. 1998Pitfalls in the interpretation of MR cholangiopancreatographyAJR17010551059PubMed
19.
Zurück zum Zitat Romagnuolo, J, Bardou, M, Rahme, E, et al. 2003Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary diseaseAnn Intern Med139547557PubMed Romagnuolo, J, Bardou, M, Rahme, E,  et al. 2003Magnetic resonance cholangiopancreatography: a meta-analysis of test performance in suspected biliary diseaseAnn Intern Med139547557PubMed
20.
Zurück zum Zitat Irie, H, Honda, H, Kuroiwa, T, et al. 2001Pitfalls in MR cholangiopancreatographic interpretationRadiographics212337PubMed Irie, H, Honda, H, Kuroiwa, T,  et al. 2001Pitfalls in MR cholangiopancreatographic interpretationRadiographics212337PubMed
21.
Zurück zum Zitat Yamashita, Y, Abe, Y, Tang, Y, et al. 1997In vitro and clinical studies of image acquisition in breath-hold MR cholangiopancreatography: single-shot projection technique versus multislice techniqueAJR16814491454PubMed Yamashita, Y, Abe, Y, Tang, Y,  et al. 1997In vitro and clinical studies of image acquisition in breath-hold MR cholangiopancreatography: single-shot projection technique versus multislice techniqueAJR16814491454PubMed
22.
Zurück zum Zitat Lopera, JE, Soto, JA, Munera, F 2001Malignant hilar and perihilar biliary obstruction: use of MR cholangiography to define the extent of biliary ductal involvement and plan percutaneous interventionsRadiology2209096PubMed Lopera, JE, Soto, JA, Munera, F 2001Malignant hilar and perihilar biliary obstruction: use of MR cholangiography to define the extent of biliary ductal involvement and plan percutaneous interventionsRadiology2209096PubMed
23.
Zurück zum Zitat Boraschi, P, Braccini, G, Gigoni, R, et al. 1999MR cholangiopancreatography: value of axial and coronal fast spin-Echo fat-suppressed T2-weighted sequencesEur J Radiol.32171181CrossRefPubMed Boraschi, P, Braccini, G, Gigoni, R,  et al. 1999MR cholangiopancreatography: value of axial and coronal fast spin-Echo fat-suppressed T2-weighted sequencesEur J Radiol.32171181CrossRefPubMed
24.
Zurück zum Zitat Kondo, H, Kanematsu, M, Shiratori, Y, et al. 1999Potential pitfalls of MR cholangiopancreatography: right hepatic arterial impression of the common hepatic ductJ Comput Assist Tomogr236062CrossRefPubMed Kondo, H, Kanematsu, M, Shiratori, Y,  et al. 1999Potential pitfalls of MR cholangiopancreatography: right hepatic arterial impression of the common hepatic ductJ Comput Assist Tomogr236062CrossRefPubMed
25.
Zurück zum Zitat Papanikolaou, N, Prassopoulos, P, Eracleous, E, et al. 2001 Contrast-enhanced magnetic resonance cholangiography versus heavily T2-weighted magnetic resonance cholangiographyInvest Radiol.36682686CrossRefPubMed Papanikolaou, N, Prassopoulos, P, Eracleous, E,  et al. 2001 Contrast-enhanced magnetic resonance cholangiography versus heavily T2-weighted magnetic resonance cholangiographyInvest Radiol.36682686CrossRefPubMed
26.
Zurück zum Zitat Yoshikawa, K, Inoue, Y, Akahane, M, et al. 2003Phantom and animal studies of a new hepatobiliary agent for MR imaging: comparison of Gd-DTPA-DeA with Gd-EOB-DTPAJ Magn Reson Imaging18204209CrossRefPubMed Yoshikawa, K, Inoue, Y, Akahane, M,  et al. 2003Phantom and animal studies of a new hepatobiliary agent for MR imaging: comparison of Gd-DTPA-DeA with Gd-EOB-DTPAJ Magn Reson Imaging18204209CrossRefPubMed
27.
Zurück zum Zitat Schima, W, Fugger, R, Schober, E, et al. 2002Diagnosis and staging of pancreatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CTAJR179717724PubMed Schima, W, Fugger, R, Schober, E,  et al. 2002Diagnosis and staging of pancreatic cancer: comparison of mangafodipir trisodium-enhanced MR imaging and contrast-enhanced helical hydro-CTAJR179717724PubMed
28.
Zurück zum Zitat Farrell, RJ, Noonan, N, Mahmud, N, et al. 2001Potential impact of magnetic resonance cholangiopancreatography on endoscopic retrograde cholangiopancreatography workload and complication rate in patients referred because of abdominal painEndoscopy33688675CrossRef Farrell, RJ, Noonan, N, Mahmud, N,  et al. 2001Potential impact of magnetic resonance cholangiopancreatography on endoscopic retrograde cholangiopancreatography workload and complication rate in patients referred because of abdominal painEndoscopy33688675CrossRef
29.
Zurück zum Zitat NIH 2002state-of-the-science statement on endoscopic retrograde cholangiopancreato-graphy (ERCP) for diagnosis and therapyNIH Consens State Sci Statement19126 NIH 2002state-of-the-science statement on endoscopic retrograde cholangiopancreato-graphy (ERCP) for diagnosis and therapyNIH Consens State Sci Statement19126
30.
Zurück zum Zitat Lee, MG, Lee, HJ, Kim, MH, et al. 1997Extrahepatic biliary diseases: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatographyRadiology202663669PubMed Lee, MG, Lee, HJ, Kim, MH,  et al. 1997Extrahepatic biliary diseases: 3D MR cholangiopancreatography compared with endoscopic retrograde cholangiopancreatographyRadiology202663669PubMed
31.
Zurück zum Zitat Semelka, RC, Shoenut, JP, Kroeker, MA, et al. 1992Bile duct disease: prospective comparison of ERCP, CT, and fat suppression MRIGastrointest Radiol.17347352PubMed Semelka, RC, Shoenut, JP, Kroeker, MA,  et al. 1992Bile duct disease: prospective comparison of ERCP, CT, and fat suppression MRIGastrointest Radiol.17347352PubMed
32.
Zurück zum Zitat Geier, A, Nguyen, HN, Gartung, C, et al. 2000MRCP and ERCP to detect small ampullary carcinomaLancet35616071608CrossRefPubMed Geier, A, Nguyen, HN, Gartung, C,  et al. 2000MRCP and ERCP to detect small ampullary carcinomaLancet35616071608CrossRefPubMed
33.
Zurück zum Zitat Irie, H, Honda, H, Shinozaki, K, et al. 2002MR imaging of ampullary carcinomasJ Comput Assist Tomogr26711717CrossRefPubMed Irie, H, Honda, H, Shinozaki, K,  et al. 2002MR imaging of ampullary carcinomasJ Comput Assist Tomogr26711717CrossRefPubMed
35.
Zurück zum Zitat Adamek, HE, Albert, J, Breer, H, et al. 2000Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective controlled studyLancet356190193CrossRefPubMed Adamek, HE, Albert, J, Breer, H,  et al. 2000Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective controlled studyLancet356190193CrossRefPubMed
36.
Zurück zum Zitat Lim, JH, Kim, MH, Kim, TK, et al. 2003Papiliary neoplasms of the bile duct that mimic biliary stone diseaseRadiographics23447455PubMed Lim, JH, Kim, MH, Kim, TK,  et al. 2003Papiliary neoplasms of the bile duct that mimic biliary stone diseaseRadiographics23447455PubMed
37.
Zurück zum Zitat Huang, JF, Wang, LY, Lin, ZY, et al. 2002Incidence and clinical outcome of icteric type hepatocellular carcinomaJ Gastroenterol Hepatol17190195CrossRefPubMed Huang, JF, Wang, LY, Lin, ZY,  et al. 2002Incidence and clinical outcome of icteric type hepatocellular carcinomaJ Gastroenterol Hepatol17190195CrossRefPubMed
38.
Zurück zum Zitat Fletcher, JG, Wiersema, MJ, Farrell, MA, et al. 2003Pancreatic malignancy: value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CTRadiology2298190PubMed Fletcher, JG, Wiersema, MJ, Farrell, MA,  et al. 2003Pancreatic malignancy: value of arterial, pancreatic, and hepatic phase imaging with multi-detector row CTRadiology2298190PubMed
39.
Zurück zum Zitat Schwartz, LH, Black, J, Fong, Y, et al. 2002Gallbladder carcinoma: findings at MR imaging with MR cholangiopancreatographyJ Comput Assist Tomogr26405410CrossRefPubMed Schwartz, LH, Black, J, Fong, Y,  et al. 2002Gallbladder carcinoma: findings at MR imaging with MR cholangiopancreatographyJ Comput Assist Tomogr26405410CrossRefPubMed
40.
Zurück zum Zitat Yeh, TS, Jan, YY, Tseng, JH, et al. 2000Malignant perihilar biliary obstruction: magnetic resonance Cholangiopancreatographic findingsAm J Gastroenterol95432440CrossRefPubMed Yeh, TS, Jan, YY, Tseng, JH,  et al. 2000Malignant perihilar biliary obstruction: magnetic resonance Cholangiopancreatographic findingsAm J Gastroenterol95432440CrossRefPubMed
41.
Zurück zum Zitat Catalano, C, Pavone, P, Laghi, A, et al. 1998Pancreatic adenocarcinoma: combination of MR imaging, MR angiography and MR cholangiopancreatography for the diagnosis and assessment of resectabilityEur Radiol.8428434CrossRefPubMed Catalano, C, Pavone, P, Laghi, A,  et al. 1998Pancreatic adenocarcinoma: combination of MR imaging, MR angiography and MR cholangiopancreatography for the diagnosis and assessment of resectabilityEur Radiol.8428434CrossRefPubMed
42.
Zurück zum Zitat Gehl, HB, Urhahn, R, Bohndorf, K, et al. 1993Mn-DPDP in MR imaging of pancreatic adenocarcinoma: initial clinical experienceRadiology186795798PubMed Gehl, HB, Urhahn, R, Bohndorf, K,  et al. 1993Mn-DPDP in MR imaging of pancreatic adenocarcinoma: initial clinical experienceRadiology186795798PubMed
43.
Zurück zum Zitat Lopez Hanninen, E, Amthauer, H, Hosten, N, et al. 2002Prospective evaluation of pancreatic tumors: accuracy of MR imaging with MR cholangiopancreatography and MR angiographyRadiology2243441PubMed Lopez Hanninen, E, Amthauer, H, Hosten, N,  et al. 2002Prospective evaluation of pancreatic tumors: accuracy of MR imaging with MR cholangiopancreatography and MR angiographyRadiology2243441PubMed
44.
Zurück zum Zitat Stroszczynski, C, Gaffke, G, Gretschel, S, et al. 2003[Use of SPIO-enhanced T1- and T2-weighted images for the differentiation of liver lesions: an ROC analysis]Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr17513681375CrossRefPubMed Stroszczynski, C, Gaffke, G, Gretschel, S,  et al. 2003[Use of SPIO-enhanced T1- and T2-weighted images for the differentiation of liver lesions: an ROC analysis]Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr17513681375CrossRefPubMed
45.
Zurück zum Zitat Reimer, P, Jahnke, N, Fiebich, M, et al. 2000Hepatic lesion detection and characterization: value of nonenhanced MR imaging, superparamagnetic iron oxide–enhanced MR imaging, and spiral CT-ROC analysisRadiology217152158PubMed Reimer, P, Jahnke, N, Fiebich, M,  et al. 2000Hepatic lesion detection and characterization: value of nonenhanced MR imaging, superparamagnetic iron oxide–enhanced MR imaging, and spiral CT-ROC analysisRadiology217152158PubMed
46.
Zurück zum Zitat Takahama, K, Amano, Y, Hayashi, H, et al. 2003Detection and characterization of focal liver lesions using superparamagnetic iron oxide–enhanced magnetic resonance imaging: comparison between ferumoxides-enhanced T1-weighted imaging and delayed-phase gadolinium-enhanced T1-weighted imagingAbdom Imaging28525530CrossRefPubMed Takahama, K, Amano, Y, Hayashi, H,  et al. 2003Detection and characterization of focal liver lesions using superparamagnetic iron oxide–enhanced magnetic resonance imaging: comparison between ferumoxides-enhanced T1-weighted imaging and delayed-phase gadolinium-enhanced T1-weighted imagingAbdom Imaging28525530CrossRefPubMed
47.
Zurück zum Zitat Yoshimitsu, K, Honda, H, Jimi, M, et al. 1999MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff sinusesAJR17215351540PubMed Yoshimitsu, K, Honda, H, Jimi, M,  et al. 1999MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff sinusesAJR17215351540PubMed
Metadaten
Titel
Malignant biliary obstruction: value of imaging findings
verfasst von
C. Stroszczynski
M. Hunerbein
Publikationsdatum
01.06.2005
Erschienen in
Abdominal Radiology / Ausgabe 3/2005
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-004-0251-y

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