Radiol Clin N Am 40 (2002) 1325-1354.
Baron RL, Tublin ME, Peterson MS.
Evaluation of suspected biliary tract disease is a common radiologic problem. Advances in ultrasound, CT, and MR technology over the past decade have greatly improved our ability to evaluate the biliary tract. Often, the initial presenting problem is to delineate the presence or absence of biliary obstruction. If obstruction is determined to be present, it is incumbent upon imaging to define the level of obstruction, and if possible, the cause of obstruction.
Over the past 5 years, significant advances in MR technology have dramatically increased the role that MR plays in evaluating the biliary tract. In depth MR techniques for evaluating the biliary tract are discussed elsewhere in this issue. Similarly, material on gallbladder imaging appears elsewhere. This article will focus on the general approach to the patient with suspected biliary tract disease, and present the imaging appearances of the common bile duct (CBD) diseases encountered in the United States. Techniques to optimize CT and ultrasound to visualize the biliary tract will be discussed, but to avoid overlap with material presented elsewhere in this issue, the reader is referred to the article on MR for specific MR techniques. For detailed discussions of cholangiographic interpretation, the reader is referred to standard radiology textbooks.