Clinical application of two-dimensional contrast-enhanced ultrasonic cholangiography

Objective To investigate the clinical value of two-dimensional contrast-enhanced ultrasonic cholangiography(2D-CEUSC) in obstructive biliary tract diseases.Methods 2D-CEUSC was performed in 33 patients who underwent PTC(twenty-one cases) or T-tube(twelve cases) because of obstructive biliary tract diseases.Image quality,the visualization of branching orders and the judgment of diseases(including whether be obstructive,the level,degree and reason of obstruction) were estimated.And the results were compared with that of conventional cholangiography(CC).Results Intra-and extrahepatic bile ducts until the obstructive segments were visualized clearly in all 33 2D-CEUSC.The image quality score were well or moderate which could satisfy the diagnostic requirement.However,there was statistically significant difference compared to CC(P=0.005).The maximum visualization of bile branches in 2D-CEUSC was(3.64±0.96),not significantly different with the results(3.79±0.74) of CC(P=0.268).Thirteen of twenty-two patients with obstruction in different level and degree were detected with 2D-CEUSC.The coincidence rate of obstruction in porta hepatic,exceed 50% or complete,and tumorous obstruction was 85.71%(6/7),100%(3/3),100%(9/9) and 100%(12/12),respectively.The accurate judged amount of incomplete obstruction due to small lesions was low.Conclusion As a new method for cholangiography,2D-CEUSC is close to CC in displaying the intrahepatic biliary branches and determining the obstructive biliary tract diseases.It can be used as supplement in evaluating the biliary obstruction preoperation.