Radiation navigation in the diagnosis of obstructive diseases of the hepatopancreatoduodenal zone
Abstract
Background. There are more patients with obstructive cholestasis every year. The determination of the level of obstruction of the biliary tract is crucial for the choice of treatment tactics.
Aim. Assess the capabilities of radial navigation methods in clarifying the causes of the development of obstruction of the biliary tract, the level of occlusion and the definition of surgical tactics in this pathology.
Material and methods. The analysis of the examination results using radiation methods (ultrasound, MRI, MSCT) of 1033 patients with obstructive diseases of the hepatopancreatoduodenal zone was carried out. Ultrasound examination was performed for all patients, MRI – 810, MSCT – 219, of them in 117 cases with contrast.
Results. Ultrasound sensitivity in determining the proximal obstruction of the biliary tract was 94.9%, and in determining the type of obstruction according to Bismuth-Corlette and the stricture variant according to E.I. Galperin it was 42.6%, and in case of MRI cholangiography – 98.7%. The data on vascular invasion during MSCT coincided with the data of intraoperative revision in 18 (86.0%) observations, and for determination was the prevalence of the tumor process and the variant of confluence formation – 100%. The sensitivity of MRI in determining the central obstruction of BT was 98.9%. The sensitivity of radiation diagnostic methods in determining the resectability of a tumor was 95.4%. In the group of patients with distal obstruction of the biliary tract, the sensitivity of radiological diagnostic methods for determining the level and nature of occlusion and the degree of prevalence of the tumor process was 97.6%.
Conclusion. The most informative methods for diagnosing the level of obstruction of the biliary and pancreatic ducts and the prevalence of the pathological process in this zone are MRI and MSCT in 3D reconstruction.
Keywords:obstructive cholestasis, hepatopancreatoduodenal tumors, biliary tract, ultrasound, magnetic resonance imaging, multispiral computed tomography, radiation methods
Conflict of interests. The authors declare no conflict of interests.
For citation: Medzhidov R.T., Sultanova R.S., Karaeva A.K. Radiation navigation in the diagnosis of obstructive diseases of the hepatopancreatoduodenal zone. Clin Experiment Surg. Petrovsky J. 2020; 8 (1): 37–46. doi:10.33029/2308-1198- 2020-8-1-37-46 (in Russian)
Received 29.03.2019. Accepted 05.02.2020.
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