Structure Of Biliary Tree Research Articles

Frequency of bile duct variant anatomy on MRCP on 3.0t in liver donors.

Objective: To determine the frequency of bile duct variant using magnetic resonance cholangiopancreatography (MRCP) on a magnetic field strength of 3.0 Tesla in liver donors. Study Design: Descriptive Cross-sectional study. Setting: Department of Radiology, Armed Forces Institute of Radiology and Imaging, Military Hospital Rawalpindi. Period: May 2019 to November 2019. Methods: The research comprised people who went to the hospital for magnetic resonance cholangiopancreatography. 85 liver transplant recipients between the ages of 20 and 70 were chosen for the research. According to Yoshida categorization, bile duct variation was noted. The MRCP methodology includes multiplanar imaging, maximum intensity projection pictures, thin slab axial HASTE, thick slab coronal HASTE, and T2 3D sequence. The Siemens Avanto 3 Tesla machine was used for the study. Results: The study's participants ranged in age from 20 to 70, with a mean age of 41.73 ± 10.03 years. The majority of the 54 patients (63.53 percent) were aged 20 to 45. The male to female ratio was 1:1 among the 85 patients, with 43 (50.59 percent) men and 42 (49.41 percent) women. In my research of liver donors, 57 (67.05 percent) showed normal biliary tree structure and 28 (32.95 percent) exhibited abnormalities. Conclusion: This study concluded that normal biliary tree anatomy was seen in 67.05% and 32.95% had variations in biliary anatomy on MRCP on 3.0T in liver donors.

Intraoperative three dimensional contrast-enhanced ultrasonic cholangiography in adult living liver donors

Objective To assess the feasibility of intra-operative three dimensional contrast-enhanced ultrasonic cholangiography (IO-3D-CEUSC) in adult living liver donors. Methods IO-3D-CEUSC was performed in 8 adult living liver donors. Image quality of IO-3D-CEUSC was evaluated. The visualization of branching orders,coincidence of morphous and biliary variation in IO-3D-CEUSC were compared with those of intraoperative cholangiography using fluoroscopy (IOC). Results The three dimensional biliary tree structures were visualized in all 8 IO-3D-CEUSC. The image quality in the right livers was higher than that of the left livers (P=0.033). The maximum visualization of branching orders in IO-3D-CEUSC was 3.9±0.8,which was equal to the result of IOC (3.7±0.9, P=0.443). The coincidence of morphous was excellent when compared the images between IO-3D-CEUSC and IOC. Two cases with biliary anatomical variation were detected by IO-3D-CEUSC and confirmed by IOC and surgical finding. The time consumption of IO-3D-CEUSC was (10.5±3.1) minutes. No adverse reactions to SonoVue occurred in the donors or recipients during the operation and follow-up. Conclusions IO-3D-CEUSC is a new technique which may be an useful supplement to IOC in evaluation of biliary anatomy and variation before graft harvesting in living donor liver transplantation. Key words: Ultrasonography; Microbubbles; Liver transplantation; Cholangiography

Localization of adipose tissue embedded biliary tree vessels by use of near-infrared diffuse photon propagation models: a computational feasibility study

Biliary tree structures are embedded in adipose tissue and, therefore, cannot be visualized directly by the surgeon during cholecystectomy operations. This can lead to inadvertent injuries with serious complications for the patient. Computational studies were performed to assess the feasibility of noninvasively localizing these structures from spectrally resolved near-infrared reflectance measurements. Methodologies were developed for vessel localization, both on the adipose tissue surface and depthwise, by use of semi-infinite and two-layer models of diffuse photon propagation in tissues, respectively. The simulation results, along with some preliminary experimental measurements on tissue-simulating phantoms, prove the feasibility of these methods and show promise for their future clinical application.

Reconstruction of biliary structure in 2D MRCP images using multi-scale analysis

Magnetic resonance cholangio pancreatography (MRCP) has become a reference technique for biliary tree analysis. Typical MRCP images, however, suffer from difficulty in distinguishing the structure of the biliary tree in order to identify abnormalities, for clinical diagnosis. For efficiency in analysing MRCP image series, the need arises for the use of semi-automated image processing techniques. A segment-based multi-scale approach is described, incorporated with image selection, enhancement and watershed segmentation, to identify and reconstruct the hierarchical biliary tree structure in 2D MRCP images. The results achieved may be further extended to higher dimensional images.

Discontinuous Region Growing Scheme for Preliminary Detection of Tumor in MRCP Images

Tumors are generally difficult to detect in Magnetic Resonance (MR) images as they can be of varying intensities and do not appear as clear structures on these images. This difficulty is more prominent in MR Cholangiopancreatography (MRCP), which is the MR technology using a special sequence of T2-weighted imaging to identify the biliary tract, pancreatic duct, and gallbladder in the liver region, as MRCP images are more noisy in nature and are acquired for a more focused area with too much flexibility in position orientation for convenient computer-aided diagnosis. Based on the principle that the tumor mass manifests itself as blockage of the biliary tree structure, this paper introduces a technique that uses a region growing algorithm to identify discontinuities in the biliary tree as a means to preliminary detection of a possible tumor, in a fashion similar to the visual observation used by most radiologists in making their preliminary diagnosis. Through the use of appropriate image normalization, watershed segmentation, thresholding, rule-based region growing, and region analysis, the proposed technique is shown in this paper to be successful in identifying MRCP images with liver carcinoma from those with normal liver. Acquisition standardization, interactive image selection, and optimum image orientation will further enhance the accuracy of this proposed scheme for use in aiding clinical diagnosis at medical institutions.

Anatomic variation of extrahepatic biliary tree structures: importance in treatment planning for radiation therapy.

To demonstrate the variable location of biliary tree components and to assess two treatment planning rules of thumb used for locating porta hepatic nodes for radiation therapy. The distance of the common hepatic duct bifurcation and duodenal papilla from adjacent vertebral bodies was measured on 34 cholangiograms, and their relationships to particular vertebral body levels were recorded. Adequacy of treatment volume to encompass porta hepatic lymph nodes was evaluated in 30 of these cholangiograms by constructing radiation portals according to the two rules of thumb. Location of the common hepatic duct bifurcation and duodenal papilla varied widely. The treatment portal encompassed 13% (four of 30) of cases when the first rule of thumb was used and 80% (24 of 30) of cases when the second rule of thumb was used. The wide variability of location of extrahepatic biliary tree structures suggests the need for individualized treatment planning so that sensitive and dose-limiting healthy tissues can be optimally excluded from radiation treatment portals. Computed tomography and other imaging modalities enable precise location of biliary tree components for radiation treatment planning.

Three-dimensional reconstruction of biliary tract from biplane projections

Over the past few years, very little has been done in the area of 3-D reconstruction of the bile duct. Since the system in use for 3-D visualization of the biliary tree is built by surgical or autopsy materials, it generally cannot be applied to clinical diagnosis. In this paper, an algorithm for three-dimensional reconstruction of the biliary tree from two mutually orthogonal is presented to provide accurate and reproducible 3-D information of the biliary tree structure. It has been proven to be useful in diagnosis prior to operation or non-surgical treatment, particularly, obstructive stones can be visualized by using a transparency technique. As experiments demonstrated, the proposed method can be used as a useful tool for the visualization of 3-D structure of biliary tree in clinical applications.