Diagnosis of PBM by MD-CT and DIC-CT

Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall. PBM can be diagnosed if the pancreaticobiliary junction outside the wall is shown in multi-planar reconstruction images provided by multidetector row computed tomography (MD-CT). A total of 29 cases were diagnosed with PBM by MD-CT. Three studies have investigated the capability of MD-CT to diagnose PBM, including the present study. These studies reported only a few cases ranging from 9 to 46 cases. The detection rate for PBM lesion is 100% in adults and 19.5% in children. A major advantage of drip infusion cholangiography with CT (DIC-CT) is that it can detect more dynamic and physiological bile flows. In addition, using DIC-CT, it is possible to detect biliopancreatic reflux, which is physiologically correlated with PBM. For biliopancreatic reflux, the detection rates of DIC-CT in children are 40.0% and 63.6%. This rate was not reported in adults. Investigation involving adults is still anticipated.