Minimum intensity projections of the biliary system using 16-channel multidetector computed tomography in patients with biliary obstruction: comparison with MRCP.

The objective was the evaluation of minimum intensity projections (MinIP) of 16-channel multidetector computed tomography (MDCT) data for the visualization of biliary ducts with magnetic resonance cholangiopancreatography (MRCP) as reference method. Twenty-five patients with biliary obstruction who received MDCT of the abdomen and MRCP without subsequent interventions were analysed. Coronal and axial MinIP were reconstructed from the MDCT-data. The evaluation of image quality and the quantitative comparison to MRCP was performed by two observers in consensus. The additional diagnostic value of MinIP compared with conventionally visualised MDCT was assessed by three independent observers. With MRCP as the reference method, MinIP was superior to conventional MDCT concerning the visualization of the extent of bile duct dilatation (r, 1.000 vs 0.699) and the correlation of diameter measurement (r, 0.979 vs 0.942). Subsidiary to conventional MDCT, MinIP revealed an improvement of visualization of the biliary system in 73% of cases. Concerning the additional diagnostic value, MinIP allowed for a better definition of the obstruction site in 13% of patients, and in one patient a change of diagnosis was observed. Thus, MinIP can improve the diagnostic assessment of biliary obstructions in MDCT imaging.