Imaging the liver and biliary tract

A variety of modalities is available to image the liver and biliary tract, many offering complementary information; a combination of techniques is often required to make the diagnosis or determine optimal patient management. Ultrasonography (US) is commonly used as the primary investigation as it is safe, cheap and widely available. Computed tomography (CT) has a central role in emergency imaging, cancer diagnosis and staging, surgical planning and assessment of treatment response.

Magnetic resonance imaging (MRI) is excellent for interrogating the liver parenchyma, and is the modality of choice for characterizing a focal liver lesion and non-invasive investigation of the biliary tree. Hepatobiliary contrast agents and diffusion-weighted imaging have further improved the accuracy of MRI. This article describes the role of each of these modalities, highlighting several common benign and malignant hepatobiliary disease processes. Other less commonly used modalities such as positron emission tomography-CT, cholescintigraphy and endoscopic ultrasound/cholangioscopy are summarized.

Keywords

Bile ductsbiliary tract diseasescholangiographycomputed tomographyliverliver diseasesmagnetic resonance imagingMRCPpositron emission tomographyultrasonography