ArticleEmergency radiology2026
Can contrast-enhanced CT assist in the early assessment of biliary obstruction? A quantitative attenuation-based study.
Article in Emergency radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the diagnostic utility of bile duct attenuation measured on contrast-enhanced computed tomography (CT) in differentiating choledocholithiasis, malignant biliary obstruction, benign biliary obstruction, and cholangitis.
methodsThis retrospective study included 208 patients who underwent contrast-enhanced abdominal CT followed by endoscopic retrograde cholangiopancreatography (ERCP) within three days. Intraductal bile attenuation was measured using two region of interest (ROI) techniques (elliptical and 4-point), with all measurements obtained strictly from bile-filled ductal segments. Secondary morphologic features were also assessed. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, and multivariate logistic regression identified independent predictors of malignancy.
resultsMean attenuation values were significantly higher in malignant obstruction and choledocholithiasis than in benign biliary obstruction and cholangitis (p < 0.001). For malignant obstruction, the 4-point method yielded 96% sensitivity and 81% specificity at a cut-off of ≥ 29 HU (AUC: 0.97), while the elliptical method yielded 100% sensitivity and 80% specificity at ≥ 60 HU (AUC: 0.95). Elliptical ROI attenuation and bile duct wall thickness were independent predictors of malignancy (p = 0.010 and p < 0.001, respectively). Interobserver agreement was excellent for both techniques (ICC > 0.89).
conclusionWhen measured strictly within bile-filled ductal segments, CT-based attenuation provides useful quantitative information for differentiating common causes of biliary obstruction. Combined with ductal wall thickness and secondary morphologic features, attenuation analysis may enhance the diagnostic value of routine contrast-enhanced CT, particularly in settings where advanced imaging modalities are limited or delayed.
Indexed as
Identifiers
41286213What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.