الفهرس 
Introduction & Aim Of The WorkOnly 14 pages are availabe for public view
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Abstract
Although many imaging techniques including ultrasonography, CT scan, MRCP, PTC and ERCP, each can be used to evaluate biliary obstruction, each technique still has some limitations. According to the previous literatures the sensitivity of ultrasound for detection of choledocholithiasis ranged from 20-80%. (Pasanen et al, 1993)
MRCP offers a high diagnostic accuracy in evaluation of biliary duct pathology , however, the limited availability, high cost, and long examination time still limit its use. (Coakley and Schwartz, 1999)
ERCP has some advantages over other noninvasive techniques since it provides both diagnosis and therapeutic intervention in the same setting. Biopsy can also be performed to establish tissue diagnosis. However, ERCP does not provide extraluminal information. Moreover, it has a failure rate of 3-10% and 0.5-5% rate of complications, including adverse reaction from sedatives, pancreatitis, perforation of the gastrointestinal tract, bleeding, cholangitis, sepsis, and death ( Baron et. Al, 2002)
The recent implementation of MDCT scan and post-processing image reconstruction techniques has facilitated a better visualization of the biliary system. With MPR technique, the biliary duct anatomy can be displayed in various planes. Moreover, MinIP technique enables us to depict a small biliary duct and pancreatic duct more clearly, since it displays only the pixel of lowest attenuation within the range of a slab thickness. This technique offers the one-step evaluation of the biliary tree and the surrounding structures. Thus, it allows a complete and definitive preoperative staging of the malignant diseases (Kim et al, 2005)
Several investigators have reported the usefulness of MDCT cholangiography using MPR and MinIP technique without cholangiographic contrast agents. With this technique, the detection of biliary duct abnormalities and stones greatly depends on the image quality provided with multidetector CT scan.