Type:
Educational Exhibit
Keywords:
Abdomen, Biliary Tract / Gallbladder, MR-Cholangiography, CT, Ultrasound, Diagnostic procedure, Congenital
Authors:
E. MANAVI1, E. Stavride2, M. Theodorou1, M. Kosmidou1, A. Theodorakopoulos1; 1THESSALONIKI/GR, 2Thessaloniki, Thessaloniki/GR
DOI:
10.26044/ecr2019/C-3414
Findings and procedure details
The diagnosis of biliary cyst can be suspected,
but is usually confirmed by imaging techniques.
US is frequently the first step assessment tool in bile duct cysts.
The diagnosis of bile duct cysts through US can be made by the observation of the cystic mass connected with the bile ducts but separate from the gallbladder [26].
In addition to the evaluation of any dilatations in the intra- and extrahepatic bile ducts,
US may also reveal potential accompanying cholelithiasis or choledocholithiasis [26].
Still MRCP is applied to evaluate the dimensions and location of the cyst or any concurrent pathologies before the surgery.
Although ERCP is accepted as the golden standard in the diagnosis,
it is not performed as the first step due to its invasive character.
ERCP may increase the risk of complications in this patient group or fail to delineate both the biliary and pancreatic duct.
Therefore,
the MRCP may be a superior diagnostic tool over the ERCP for patients with choledochal cysts.
Computed tomography also demonstrates the biliary tract and the pancreatic duct.
However,
axial cross sections are inadequate to describe the dimensions and the length of the involved segment on their own.
Moreover,
the method has disadvantages due to high-dose radiation exposure and the intravenous contrast agent,
especially in children [26,
27].