A New modality in Cholangiography: Percutaneous Ultrasonic Cholangiography with SonoVue for Evaluating Dilated Biliary Tract

  • Professor Xiaoyan Xie, Department of Ultrasonic,the First Affiliated Hospital, Sun Yat-Sen University, China
  • Dr Luyao Zhou, Department of Ultrasonic,the First Affiliated Hospital, Sun Yat-Sen University, China
  • Professor Ming Kuang, Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, China
  • Professor Huixiong Xu, Department of Ultrasonic,the First Affiliated Hospital, Sun Yat-Sen University, China
  • Dr Zuofeng Xu, Department of Ultrasonic,the First Affiliated Hospital, Sun Yat-Sen University, China
  • Professor Xiaoyu Ying, Department of Hepatobiliary Surgery, the First Affiliated Hospital, Sun Yat-Sen University, China
  • Dr Bei Huang, Department of Ultrasonic,the First Affiliated Hospital, Sun Yat-Sen University, China
  • Prof Ming-De Lu, Department of Hepatobiliary Surgery,the First Affiliated Hospital, Sun Yat-Sen University, China

    • Purpose: To evaluate the feasibility of percutaneous ultrasonic cholangiography(PUSC) with contrast agent SonoVue in evaluating the obstructive bile duct diseases.
    Method: 58 patients with obstructive jaundice who underwent ultrasound-guided percutaneous transhepatic cholangial drainage(PTCD) were ruled in. Percutaneous ultrasonic cholangiography (PUSC) with contrast agent SonoVue administrated through the PTCD tube and Percutaneous transhepatic cholangiography were carried out in each patient, respectively. PUSC imaging was compared with PTC imaging for each patient in displaying the dilated bile duct tree, detecting the obstruction levels and obstruction causes in patients with obstructive jaundice.
    Result: Three patients complained right upper abdominal pain during PUSC procedure while 25 patients complained analogous symptoms during PTC procedure. The accuracy of PUSC in determining the level of hilar obstruction and exhepaptic obstruction was 100%(26/26) and 93.3%(30/32), while the accuracy of PTC was both 100%, the difference between them were not statistically significant. The accuracy of PUSC in determining the cause of hilar obstruction and exhepatic obstruction was 92.3%(24/26) and 93.8%(30/32), respectively, while the accuracy of PTC was 84.6%(22/26) and 75%(24/34), respectively. The difference between PUSC and PTC in determining the cause of hilar obstruction was not stastically significant (P=0.675>0.05), but the difference between them in determining the cause of exhepatic obstruction was stastically significant(P=0.039<0.05).
    Conclusion: PUSC is a safe and feasible. It is comparable to PTC in displaying the dilated bile duct tree, detecting the obstructive levels and obstruct causes in patients with obstructive jaundice. It is suggest PUSC may be used as a new modality in cholangiography.