J Korean Radiol Soc.
1994 Sep;31(3):495-500.
Extrahepatic Biliary Obstruction: CT Patterns of Ductal Dilatation and Changes of Extrahepatic Ductal Wall
Abstract
- PURPOSE
To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the
differential diagnosis of extrahepatic biliary obstruction.
MATERIALS AND METHODS
CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27
malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement,
and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal
dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness.
RESULTS
Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were
more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic
ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and
central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign
cases.
CONCLUSION
These results may help to interpret the CT findings of extrahepatic biliary obstruction,
particularly when the cause of biliary obstruction is uncertain.