Tanaka Toshiyuki, Akiyoshi Hideo, Mie Keiichiro, Shimazaki Hitoshi, Ohashi Fumihito
1 Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.
2 Kinki Animal Medical Training Institute, Osaka, Japan.
J Feline Med Surg. 2018 Dec;20(12):1173-1176. doi: 10.1177/1098612X17738615. Epub 2017 Dec 1.
Ultrasonography can detect extrahepatic biliary obstructions. However, visualisation of part of the bile duct using ultrasonography can be technically difficult if there is overlying bowel gas. This study investigated the safety and value of drip infusion cholangiography with computed tomography (DIC-CT) in the visualisation of the bile duct in healthy cats and extrahepatic biliary obstruction in cats with cholelithiasis.
DIC-CT was performed in three healthy cats and two cats with cholelithiasis. Meglumine iotroxate was administered by intravenous drip infusion over 30 mins. The attenuation value was measured perpendicular to the lumen by a region of interest covering about 50% of the area of the lumen.
The bile ducts were visualised successfully with DIC-CT in all healthy cats without any significant adverse events. The attenuation value of the contrast medium was 271 ± 37 HU. In the two cats with cholelithiasis, the presence or absence of extrahepatic biliary obstruction was determined using DIC-CT without any significant adverse events. The attenuation value of cholelithiasis in the cat with an extrahepatic biliary obstruction was 933 ± 119 HU. In the cat with no extrahepatic biliary obstruction, the attenuation value of the contrast medium was 249 ± 53 HU and the attenuation value of cholelithiasis was 167 ± 28 HU.
DIC-CT visualises bile ducts and detects obstructive biliary disease without significant adverse events. Therefore, it appears to be a safe procedure for visualisation of the bile duct in cats.
超声检查可检测肝外胆管梗阻。然而,如果存在覆盖其上的肠气,使用超声检查可视化部分胆管在技术上可能具有挑战性。本研究调查了滴注式计算机断层扫描胆管造影(DIC-CT)在健康猫胆管可视化以及胆结石猫肝外胆管梗阻检测中的安全性和价值。
对3只健康猫和2只患有胆结石的猫进行DIC-CT检查。静脉滴注碘曲仑30分钟。通过覆盖管腔面积约50%的感兴趣区域垂直于管腔测量衰减值。
所有健康猫均通过DIC-CT成功实现胆管可视化,且无任何明显不良事件。造影剂的衰减值为271±37HU。在2只患有胆结石的猫中,使用DIC-CT确定了肝外胆管梗阻的有无,且无任何明显不良事件。肝外胆管梗阻猫的胆结石衰减值为933±119HU。在无肝外胆管梗阻的猫中,造影剂的衰减值为249±53HU,胆结石的衰减值为167±28HU。
DIC-CT可实现胆管可视化并检测梗阻性胆道疾病,且无明显不良事件。因此,它似乎是一种用于猫胆管可视化的安全方法。