AUTHOR=Zhou Sheng-Li , Ji Ting-Ju , Zhou Xin-Yu , Xu Lei , Xin Yi , Huang Qiu-Ju 

TITLE=Application value of computed tomography and magnetic resonance imaging three-dimensional reconstruction and digital subtraction angiography in percutaneous transhepatic cholangial drainage

JOURNAL=Frontiers in Surgery

VOLUME=Volume 9 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.932901

DOI=10.3389/fsurg.2022.932901

ISSN=2296-875X

ABSTRACT=Objective: To explore the value of computed tomography (CT), magnetic resonance imaging (MRI) three-dimensional (3D) reconstruction, and conventional digital subtraction angiography (DSA) fluoroscopy in percutaneous trans-hepatic cholangial drainage (PTCD). Methods: The clinical data of 180 patients with obstructive jaundice requiring PTCD from December 2017 to December 2021 were retrospectively analyzed. Following PTCD, CT, MRI 3D reconstruction, and conventional DSA fluoroscopy were conducted, after which the surgical success rates, liver function results, and post-surgical complications were compared. Results: The puncture accuracies under CT, MRI 3D reconstruction, and conventional DSA fluoroscopy were 90.0% (54/60), 96.7% (58/60), and 80% (48/60), respectively. The degree of jaundice and epigastric discomfort was relieved in all three groups after surgery, while a significant reduction in the levels of total bilirubin and direct bilirubin was observed relative to the levels before surgery (P < 0.05). The incidence of complications in the CT, MRI 3D reconstruction, and conventional DSA fluoroscopy groups was 6.7% (4/60), 3.3% (2/60), and 13.3% (8/60), respectively, and the differences among the three groups were statistically significant (P < 0.05). Conclusion: Conducting conventional enhanced CT and MRI scans in patients before surgery might be more practical than the conventional puncture method. Among the methods under study, MRI 3D reconstruction was found to be both safer and more feasible than CT 3D reconstruction and conventional DSA fluoroscopy in PTCD. Use of MRI 3D reconstruction could reduce the degree of jaundice, improve the success rate of surgery, reduce the incidence of complications due to surgery, and improve the patients’ tolerance of surgery.