OBJECTIVETo investigate the feasibility of multi-slice spiral CT (MSCT) for cholangiopancreatography without cholangio-contrast.

METHODSTen patients without any digestion system diseases and 24 patients with suspected pancreatic malignancy received the 16-slice spiral CT multi-phased contrast-enhanced scanning. The images of patients without any digestion system diseases and cancer-suffered patients were curved reformatted (CR) technique to perform the structure of pancreatic duct, common bile duct, and ampulla. The cholangiopancreatical systems of the cancer suffered patient were reconstructed through volume rendering technique (VRT), minimum intensity projection (MinIP), and indirect minimum intensity projection (IMinIP). The results of patients without any digestion system diseases in curved multiplanar reconstruction were analyzed; meanwhile display rates of the pancreatic duct, common bile duct, and ampulla were evaluated.

RESULTSof the four different cholangiopancreatographies were compared.

RESULTSThe display rate of pancreatic duct in the CR images was 90.0 (9/10) with an average diameter of (2.63 +/- 0.51) mm. Sub-pancreatic duct could be seen in 88.9% (8/9) of them. The display rate of common bile duct in the CR images was 100% (10/10) with an average diameter of (7.45 +/- 1.12) mm. The display rate of ampulla was 60.0 (6/10), which was affected by the filling status of duodenum. The cholangiopancreatography using CR, VRT, MinIP, and IMinIP for patients with pancreatic cancer reveal the whole pancreatic and common bile duct, and the modality of distal obstructed bile duct. The result showed that IminIP got the best outcome (98.6%), while VRT got the worst (68.1%).

CONCLUSIONThe negative CT cholangiopancreatography is a simple and non-invasive examination. It reflects both the 3-dimensional cholangio-pancreatic anatomical structure and its adjacent condition. It has curtain clinical application values, especially for patients with obstructed duct system.