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CEUS Liver: Biliary Tract
Zeno Spârchez, MD, PhD
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KEY FACTS

  • CEUS Indications

    • Imaging

      TERMINOLOGY

      • Definitions

        • Biliary obstruction involves blockage of any duct that carries bile from liver to gallbladder or from gallbladder to small intestine
        • Main causes of biliary obstruction
          • Choledocholithiasis
          • Pancreatic
          • Biliary tumors
        • Most common malignant biliary tumor is intrahepatic cholangiocarcinoma with 2 subtypes
          • Peripheral
          • Hilar
        • Less common malignant biliary tumors
          • Intrabiliary metastases
          • Cholangiohepatoma
          • Ampullary carcinoma
          • Hepatocellular carcinoma invading bile ducts
          • Cystadenocarcinoma
        • Benign biliary tumors
          • Adenomas
          • Hamartomas
          • Cystadenomas
        • Nontumoral biliary pathology refers to
          • Portal hypertensive biliopathy
          • (Peri-) ductal inflammation
          • Nontumoral biliary masses
            • Sludge, clot, or pus

      CEUS Indications

      • Biliary Tree Imaging

        CEUS TECHNIQUE

        • General Discussion

          • Pitfalls

            IMAGING

            • Biliary Duct Dilatation

              • Biliary Abscesses

                • Biliary Hamartoma (von Meyenberg Complexes)

                  • Biliary Cystadenoma

                    • Cholangiocarcinoma

                      • Intrabiliary Metastasis

                        • Villous Adenoma

                          • Ampullary Carcinoma

                            • Other Lesions

                              Selected References

                              1. Cokkinos DD et al: Contrast-enhanced ultrasound examination of the gallbladder and bile ducts: A pictorial essay. J Clin Ultrasound. 46(1):48-61, 2018
                              2. Sidhu PS et al: The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (long version). Ultraschall Med. 39(2):e2-e44, 2018
                              3. Sparchez Z et al: Role of CEUS in the diagnosis of gallbladder disease. Med Ultrason. 14(4):326-30, 2012
                              4. Meacock LM et al: Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound. Br J Radiol. 83(991):615-27, 2010
                              5. Xu HX et al: Enhancement pattern of hilar cholangiocarcinoma: contrast-enhanced ultrasound versus contrast-enhanced computed tomography. Eur J Radiol. 75(2):197-202, 2010
                              6. Xu HX: Contrast-enhanced ultrasound in the biliary system: potential uses and indications. World J Radiol. 1(1):37-44, 2009
                              7. Chen LD et al: Enhancement patterns of intrahepatic cholangiocarcinoma: comparison between contrast-enhanced ultrasound and contrast-enhanced CT. Br J Radiol. 81(971):881-9, 2008
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • CEUS Indications

                                • Imaging

                                  TERMINOLOGY

                                  • Definitions

                                    • Biliary obstruction involves blockage of any duct that carries bile from liver to gallbladder or from gallbladder to small intestine
                                    • Main causes of biliary obstruction
                                      • Choledocholithiasis
                                      • Pancreatic
                                      • Biliary tumors
                                    • Most common malignant biliary tumor is intrahepatic cholangiocarcinoma with 2 subtypes
                                      • Peripheral
                                      • Hilar
                                    • Less common malignant biliary tumors
                                      • Intrabiliary metastases
                                      • Cholangiohepatoma
                                      • Ampullary carcinoma
                                      • Hepatocellular carcinoma invading bile ducts
                                      • Cystadenocarcinoma
                                    • Benign biliary tumors
                                      • Adenomas
                                      • Hamartomas
                                      • Cystadenomas
                                    • Nontumoral biliary pathology refers to
                                      • Portal hypertensive biliopathy
                                      • (Peri-) ductal inflammation
                                      • Nontumoral biliary masses
                                        • Sludge, clot, or pus

                                  CEUS Indications

                                  • Biliary Tree Imaging

                                    CEUS TECHNIQUE

                                    • General Discussion

                                      • Pitfalls

                                        IMAGING

                                        • Biliary Duct Dilatation

                                          • Biliary Abscesses

                                            • Biliary Hamartoma (von Meyenberg Complexes)

                                              • Biliary Cystadenoma

                                                • Cholangiocarcinoma

                                                  • Intrabiliary Metastasis

                                                    • Villous Adenoma

                                                      • Ampullary Carcinoma

                                                        • Other Lesions

                                                          Selected References

                                                          1. Cokkinos DD et al: Contrast-enhanced ultrasound examination of the gallbladder and bile ducts: A pictorial essay. J Clin Ultrasound. 46(1):48-61, 2018
                                                          2. Sidhu PS et al: The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (long version). Ultraschall Med. 39(2):e2-e44, 2018
                                                          3. Sparchez Z et al: Role of CEUS in the diagnosis of gallbladder disease. Med Ultrason. 14(4):326-30, 2012
                                                          4. Meacock LM et al: Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound. Br J Radiol. 83(991):615-27, 2010
                                                          5. Xu HX et al: Enhancement pattern of hilar cholangiocarcinoma: contrast-enhanced ultrasound versus contrast-enhanced computed tomography. Eur J Radiol. 75(2):197-202, 2010
                                                          6. Xu HX: Contrast-enhanced ultrasound in the biliary system: potential uses and indications. World J Radiol. 1(1):37-44, 2009
                                                          7. Chen LD et al: Enhancement patterns of intrahepatic cholangiocarcinoma: comparison between contrast-enhanced ultrasound and contrast-enhanced CT. Br J Radiol. 81(971):881-9, 2008