Whenever there is bile duct dilatation, the first priority is to look for obstruction. If there is an obstruction, we first look for gallstones in the bile duct. If there are no gallstones involved, we then look for strictures. The differential diagnosis for a stricture is based on the location.
Dilated bile ducts can be seen on various imaging studies like ultrasound, CT and MRI. There are many causes, some of which can be benign and ignored while others can be life threatening and an emergency.
CT cholangiography using iodinated contrast agents such as intravenous meglumine iotroxate (which is taken up by the liver and excreted in bile) depicts bile duct stones more accurately.
The bile ducts in the liver are normally very small and are often barely visible on CT. When they become mildly dilated, you will see thin, dark, tubular structures throughout the liver branching from the hepatic hilum.
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Intrahepatic biliary dilatation is a condition where the bile ducts within the liver become enlarged, often due to an obstruction or blockage. Medical imaging plays an important role in detecting and assessing intrahepatic biliary dilatation.
Common bile duct dilation (ie, ≥ 7 mm on ultrasonography or ≥ 10 mm on CT) with clinical or biochemical features of obstruction warrants further investigation. ERCP is the initial choice if there are signs of ascending cholangitis.
We start by covering a basic approach to interpreting LFT results, the strengths and weaknesses of the biliary imaging modalities, and how and where to measure the extrahepatic bile duct.
Biliary cystic lesions, such as mucinous cystic neoplasms, intraductal papillary neoplasms of the bile duct, and Caroli disease, require careful monitoring due to their propensity to develop malignancy.
Learn about intrahepatic bile duct dilation, an imaging finding that may signal biliary obstruction, inflammation, stones, or cancer. Discover symptoms, MRI/MRCP findings, causes, and treatment options.