Comparison of the value of multidetector-row computed tomography in diagnosis of biliary obstruction reasons with the results obtained from invasive procedures

Diagnostic imaging has a fundamental contribution to non - invasive diagnosis of the reasons for biliary obstruction and screening the patients at high risk. So, this study was aimed to compare the value of multidetector-row computed tomography (MDCT) in diagnosis of biliary obstruction reasons with the results obtained from invasive procedures. In this descriptive-analytical study, 50 patients were selected by stratified sampling from January 2010 to May 2011 with diagnosis of biliary obstruction based on per clinical and sonographic results and they were evaluated by MDCT. Their radiology report was compared with the results obtained from other invasive procedures including Percutaneous Transhepatic Cholangiography (PTC), Endoscopic Retrograde Cholangiopancreaticography (ERCP), and/or surgery. Findings indicated that sensitivity, specificity, and accuracy of MDCT was 100%, 88.4%, and 94%, respectively in diagnosis of malignant reasons for biliary obstruction, 75%, 100%, and 96% in diagnosis of benignant reasons for biliary obstruction, and 94.4%, 100%, and 98% in that of gallstones. No significant relationship was found between severity of bile duct dilatation and obstructive agent’s benignancy or malignancy (P<0.001). Based on this study findings, MDCT is found a rapid, non-invasive, and highly accurate method in diagnosis of biliary obstruction reasons, differentiation between benignant obstructive agents and malignant ones, and is useful for planning prior to surgery.