Biliary tree - radiologieplzen.eu

Biliary tree
Imaging methods
- x-ray
- ultrasound
- CT
- MRI (MRCP)
- ERCP
- PTC
- intraoperative/postoperative cholangiogram
Cholecystolithiasis
- Ultrasound – the best method
- CT and X-ray are able to detect only stones containing calcium (20-30%)
- contrast x-ray methods (p.o. cholecystography, i.v. cholangiography) – history
- MRI – crebible but expensive and worse accessible
Contrast stones
p.o. cholecystography
i.v. cholangiography
Cholecystitis
- acute
- calculous
- chronic
- acalculous
Cholecystitis
Empyema
Absceding cholecysttis
Emphysematous cholecystitis
Gallbladder tumors
Polyp
Carcinoma
Biliary obstruction
- choledocholithiasis
- biliary duct stenosis - benign (postinflammatory, iatrogenic)
- malignant (tumors of biliary ducts, gallbladder, liver pancreas, duodenum)
- compression (lymph nodes, pancreatic pseudocyst, hydropic gallbladder)
Computed tomography
- Klatzskin´s tumor
MRCP
- Klatzskin´s tumor
Sclerosing cholangoitis
- primary - idiopatic
- secondary - M. Crohn, Ulc. colitis, hepatitis …
Interventional procedures
- diagnostics + therapy
Endoscopic retrograde cholangiopancreatography - ERCP
- diagnostics – biliary tree and pancreatic duct stenosis and obstruction
- interventional procedures (biopsy, stone extraction, stent implantation)
Percutaneous transhepatic cholangiography - PTC
Percutaneous transhepatic drainage - PTD
- tight stenoses and obstructions unsolvable by ERCP
Intraoperative cholangiography
Postoperative T-tube cholangiography
Pancreatic duct
Chronic pancreatitis
- enlargement or atrophy of the gland
- calcifications
- dilatation of pancreatic duct
- pancreaticolithiasis
Carcinoma of the pancreatic head
Carcinoma of pancreatic body
- dilatace pankreatiku,
- infiltrace cévních struktur