Cholangitis ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]

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Overview

Ultrasounds are the primary imaging modality for cholangitis. An ultrasound is both sensitive and specific in demonstrating biliary dilatation.

Ultrasound

An ultrasound is the primary imaging modality used to access patients with suspected acute cholangitis.[1] Ultrasounds may show dilation of the bile duct and identifies 38% of bile duct stones.[2]

  • Ultrasounds are relatively poor at identifying stones further down the bile duct, but they are both sensitive and specific in detecting biliary dilatations.
  • An ultrasound can show biliary dilatations with or without stones and debris material within the common bile duct.[3]
    • However, biliary dilatations are not always present at early stages of bile duct obsctructions, and the performance of an ultrasound in indicating choledocholithiasis is poor.[1]
  • For patients who have previously not undergone a cholecystectomy, an ultrasound allows doctors to determine the probability of choledocholithiasis, even if the stone is not directly visible.[1]
  • A main finding of ascending cholangitis on an ultrasound is the thickening of the bile duct walls.[3]
  • Ultrasound can help distinguish between cholangitis and cholecystitis (inflammation of the gallbladder), which has similar symptoms to cholangitis, but appears differently on ultrasound.[2]

References

  1. 1.0 1.1 1.2 Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM (2006). "[Acute cholangitis: imaging diagnosis and management]". J Radiol (in French). 87 (4 Pt 2): 430–40. PMID 16691174.
  2. 2.0 2.1 Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ (2000). "Diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis". Clin Radiol. 55 (1): 25–35. doi:10.1053/crad.1999.0319. PMID 10650107.
  3. 3.0 3.1 Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR (2004). "From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant". Radiographics. 24 (4): 1117–35. doi:10.1148/rg.244035149. PMID 15256633.


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