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1、DifferentiatingMalignantfromBenignCommonBileDuctStricturewithMultiphasicHelicalCT1SeungHongChoi,MD,JoonKooHan,MD,JeongMinLee,MD,KyoungHoLee,MD,SeHyungKim,MD,JaeYoungLee,MDandByungIhnChoi,MD1FromtheDepartmentofRadiologyandtheInstituteofRadiationMedicine,SeoulNationalUniversityCollegeofMedic
2、ine,ClinicalResearchInstitute,SeoulNationalUniversityHospital,28Yongon-dong,Chongno-gu,Seoul110-744,Korea.ReceivedMay2,2004;revisionrequestedJuly14;revisionreceivedAugust3;acceptedSeptember23.Supportedinpartbythe2001BK21ProjectforMedicine,Dentistry,andPharmacy.AddresscorrespondencetoJ.K.H.
3、(e-mail:hanjk@radcom.snu.ac.kr). ABSTRACTTOPABSTRACTINTRODUCTIONMATERIALSANDMETHODSRESULTSDISCUSSIONReferences PURPOSE:Toevaluateretrospectivelytheuseofmultiphasichelicalcomputedtomography(CT)todifferentiatemalignantandbenigncommonbileduct(CBD)stricturesinpatientswithonlyafocalCBDstrictur
4、eandtodeterminepredictorsforthisdifferentiation.MATERIALSANDMETHODS:Institutionalreviewboardapprovalandinformedpatientconsentwerenotrequired.Fiftypatients(35men,15women;agerange,35–87years;meanage,61.6years)withonlyafocalCBDstricturecomprisedthesampleforthisstudy(32malignantand18benignstri
5、ctures).ThediagnosisofallmalignantandfivebenignCBDstrictureswasconfirmedbyreviewingpatients'surgicalandpathologyrecords;in13benignCBDstrictures,thediagnosiswasconfirmedbymeansofclinicalfeatures.MultiphasicCTfindingswereanalyzedwithregardtothewallthickness,location,length,andenhancementpatt
6、ernoftheinvolvedCBD,theupstreamCBDdiameter,andotherfindings.CTfeaturestoidentifybenignandmalignantCBDstrictureswerecomparedbymeansofunivariateanalysisandmultivariablestepwiselogisticregressionanalysis.RESULTS:Malignantstrictureswerelonger(17.9mm±6.6[±standarddeviation])thanbenignstrictures
7、(8.9mm±6.8)(P<.0001),andupstreamCBDdiameterswerelargerinmalignantcases(22.0mm±5.4)thaninbenigncases(17.8mm±4.6)(P=.033).Theinvolvedwallthicknesswasmorethan1.5mmin26malignantcasesandthreebenigncases(P<.0001).Duringbothhepaticarterialandportalvenousphases,greate
