Eur Radiol (2005) 15: 2130–2139 DOI 10.1007/s00330-005-2809-7 HEPATOBILIARY-PANCREAS Eleni Eracleous Marios Genagritis Nicos Papanikolaou Allayioti Maria Kontou P. Prassopoullos Haris Chrysikopoulos Paul Allan Nicholas Gourtsoyiannis Received: 3 November 2004 Revised: 17 April 2005 Accepted: 6 May 2005 Published online: 8 June 2005 # Springer-Verlag 2005 Complementary role of helical CT cholangiography to MR cholangiography in the evaluation of biliary function and kinetics Abstract To explore the potential role of computed tomographic chol- angiography (CTC) in relation to magnetic resonance cholangiography (MRC) in cases in which knowledge of biliary kinetics and functional information are important for thera- peutic decisions, 31 patients (14 men and 17 women) underwent MRC followed by CTC. We examined nine post-cholecystectomy cases with right upper quadrant abdominal pain, six cases with a previous biliary-enteric anastomosis and clinical evidence of cholangitis, eight biliary strictures with pain or symptoms of cholangitis, four cases with strong clinical evi- dence of sclerosing cholangitis, three cases with suspected post-laparo- scopic cholecystectomy bile leakage, and one case with chronic pancreatitis and a common bile duct stent asso- ciated with cholangitis. In relation to MRC, CTC provided additional bili- ary functional information as follows: abnormal biliary drainage through the ampulla in 7/9 cholecystectomy cases, impaired drainage in 3/6 biliary- enteric anastomoses, and complete obstruction in 2/8 biliary strictures. CTC diagnosed early sclerosing cholangitis in 4/4 cases and confirmed suspected bile leakage in 1/3 post- laparoscopic cholecystectomy pa- tients, and the patency of the biliary stent in the patient with chronic pan- creatitis. Thus, CTC provides clini- cally important information about the function and kinetics of bile and complements findings obtained by MRC. Keywords Magnetic resonance cholangiography . Computed tomographic cholangiography . Biliary obstruction . Biliary function . Biliary kinetics . Sclerosing cholangitis . Cholecystectomy- complications . Biliary-enteric anastomosis Introduction Magnetic resonance cholangiography (MRC) is an estab- lished method for the evaluation of the biliary tree with merits [1–4] and limitations [1, 5, 6]. The major advantages of MRC in relation to endoscopic retrograde cholangio- pancreatography (ERCP) are its non-invasive nature, avoid- ance of ionising radiation, and the ability to depict the biliary tree above an obstruction or a high-grade stenosis [7]. The standard MRC technique remains a simple hydro- graphic investigation, imaging only static fluid, such as bile in the biliary tree or bilomas, peritoneal fluid, urine in the renal collecting system, cerebrospinal fluid in the spinal canal, and fluid in the cysts; it provides anatomical images but only limited information about biliary kinetics or func- tion [1, 5, 6, 8]. Contrast-enhanced computed tomographic cholangiog- raphy (CTC) has been used sporadically for patients in whom MRC was contra-indicated [9], for preoperative evaluation [10], for the detection of bile duct stones [11], and in cases where the quality of MRC images was sub- optimal [11, 12]. The purpose of the present study was to explore the potential role of CTC in cases for which biliary kinetics and functional information are important for therapeutic decisions. E. Eracleous (*) . M. Genagritis . A. M. Kontou Department of Radiology, Diagnostic Center of Ayios Therissos, Nicosia, Cyprus e-mail: elenerac@logosnet.cy.net Tel.: +357-22442630 Fax: +357-22315922 N. Papanikolaou . P. Prassopoullos . H. Chrysikopoulos . N. Gourtsoyiannis Department of Radiology, University of Crete, Heraklion, Greece P. Allan Department of Radiology, Royal Infirmary of Edinburgh, Edinburgh, UK