Imaging of the biliary tree

Question 1

What is the biliary tree?

Answer 1

The biliary tree is a system of vessels that directs these secretions from the liver, gallbladder and pancreas through a series of ducts into the duodenum.
The endpoint is the papilla of Vater

Question 2

Describe the flow of bile

Answer 2

Bile canaliculi>intralobular duct>collecting ducts>left and right hepatic ducts> common hepatic duct join with cystic duct>common bile duct joins with main pancreatic duct>hepatopancreatic ampulla (ampulla of Vater) regulated by the sphincter of Oddi

Question 3

When is ultrasound imaging indicated for the biliary tree?

Answer 3

Patients with jaundice who don’t have predisposing conditions.
Used to confirm the presence of biliary obstruction.
Obstructive processes cause dilatation of the intrahepatic and extrahepatic biliary tree.
Ultrasound may also indicate the location of the obstruction and whether it is benign or malignant.
Ultrasound is accurate, inexpensive, readily available and non-invasive for the detection of biliary obstruction.

Question 4

When is CT imaging indicated for the biliary tree?

Answer 4

Suspected biliary or pancreatic malignancy.
Contrast-enhanced abdominal CT is used when complicating conditions such as cholangitis, cholecystitis, pancreatitis are not well evaluated by ultrasound imaging.

Question 5

When is MRI imaging indicated for the biliary tree?

Answer 5

Ductal calculi.

Suspected benign causes of jaundice?