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{{Cholangitis}}


==Overview==
==Overview==
[[Ultrasounds]] (US) are the primary imaging modality for cholangitis. An US is both sensitive and specific in demonstrating biliary dilatation.
[[Ultrasounds]] are the primary imaging modality for cholangitis. An [[ultrasound]] is both [[Sensitivity (tests)|sensitive]] and [[Specificity (tests)|specific]] in demonstrating biliary dilatation.


==Ultrasound==
==Ultrasound==
*Ultrasounds may show dilation of the [[bile duct]] and identifies 38% of bile duct stones.<ref name="pmid10650107">{{cite journal |vauthors=Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ |title=Diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis |journal=Clin Radiol |volume=55 |issue=1 |pages=25–35 |year=2000 |pmid=10650107 |doi=10.1053/crad.1999.0319 |url=}}</ref>
An [[ultrasound]] is the primary imaging modality used to access patients with suspected acute cholangitis.<ref name="pmid16691174">{{cite journal |vauthors=Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM |title=[Acute cholangitis: imaging diagnosis and management] |language=French |journal=J Radiol |volume=87 |issue=4 Pt 2 |pages=430–40 |year=2006 |pmid=16691174 |doi= |url=}}</ref> [[Ultrasounds]] may show dilation of the [[bile duct]] and identifies 38% of [[bile duct]] stones.<ref name="pmid10650107">{{cite journal |vauthors=Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ |title=Diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis |journal=Clin Radiol |volume=55 |issue=1 |pages=25–35 |year=2000 |pmid=10650107 |doi=10.1053/crad.1999.0319 |url=}}</ref>
**It is relatively poor at identifying stones further down the bile duct.
*[[Ultrasounds]] are relatively poor at identifying stones further down the [[bile duct]], but they are both [[Sensitivity (tests)|sensitive]] and [[Specificity (tests)|specific]] in detecting biliary dilatations.
*An ultrasound is the primary imaging modality used to access patients with suspected acute cholangitis.<ref name="pmid16691174">{{cite journal |vauthors=Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM |title=[Acute cholangitis: imaging diagnosis and management] |language=French |journal=J Radiol |volume=87 |issue=4 Pt 2 |pages=430–40 |year=2006 |pmid=16691174 |doi= |url=}}</ref>
*An [[ultrasound]] can show biliary dilatations with or without [[Gallstone disease|stones]] and debris material within the [[common bile duct]].<ref name="pmid15256633">{{cite journal |vauthors=Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR |title=From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant |journal=Radiographics |volume=24 |issue=4 |pages=1117–35 |year=2004 |pmid=15256633 |doi=10.1148/rg.244035149 |url=}}</ref>
**It is both sensitive and specific in detecting biliary dilatations.
**However, biliary dilatations are not always present at early stages of [[bile duct]] obsctructions, and the performance of an [[ultrasound]] in demonstrating [[choledocholithiasis]] is poor.<ref name="pmid16691174">{{cite journal |vauthors=Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM |title=[Acute cholangitis: imaging diagnosis and management] |language=French |journal=J Radiol |volume=87 |issue=4 Pt 2 |pages=430–40 |year=2006 |pmid=16691174 |doi= |url=}}</ref>   
**An US can show biliary dilatations with or without stones and debris material within the [[common bile duct]].<ref name="pmid15256633">{{cite journal |vauthors=Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR |title=From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant |journal=Radiographics |volume=24 |issue=4 |pages=1117–35 |year=2004 |pmid=15256633 |doi=10.1148/rg.244035149 |url=}}</ref>
*For patients who have previously not undergone a [[cholecystectomy]], an [[ultrasound]] is helpful to determine the probability of [[choledocholithiasis]], even if the stone is not directly visible.<ref name="pmid16691174">{{cite journal |vauthors=Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM |title=[Acute cholangitis: imaging diagnosis and management] |language=French |journal=J Radiol |volume=87 |issue=4 Pt 2 |pages=430–40 |year=2006 |pmid=16691174 |doi= |url=}}</ref>  
***However, biliary dilatations are not always present at early stages of [[bile duct]] obsctructions, and the performance of an US in indicating [[choledocholithiasis]] is poor.<ref name="pmid16691174">{{cite journal |vauthors=Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM |title=[Acute cholangitis: imaging diagnosis and management] |language=French |journal=J Radiol |volume=87 |issue=4 Pt 2 |pages=430–40 |year=2006 |pmid=16691174 |doi= |url=}}</ref>   
*The main finding of ascending cholangitis on an [[ultrasound]] is the thickening of the [[bile duct]] walls.<ref name="pmid15256633">{{cite journal |vauthors=Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR |title=From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant |journal=Radiographics |volume=24 |issue=4 |pages=1117–35 |year=2004 |pmid=15256633 |doi=10.1148/rg.244035149 |url=}}</ref>  
*For patients who have previously not undergone a [[cholecystectomy]], an US allows doctors to determine the high probability of having choledocholithiasis, even if the stone is not directly visible.<ref name="pmid16691174">{{cite journal |vauthors=Gallix BP, Aufort S, Pierredon MA, Garibaldi F, Bruel JM |title=[Acute cholangitis: imaging diagnosis and management] |language=French |journal=J Radiol |volume=87 |issue=4 Pt 2 |pages=430–40 |year=2006 |pmid=16691174 |doi= |url=}}</ref>  
 
*A main finding of ascending cholangitis on an US is the thickening of the [[bile duct]] walls.<ref name="pmid15256633">{{cite journal |vauthors=Hanbidge AE, Buckler PM, O'Malley ME, Wilson SR |title=From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant |journal=Radiographics |volume=24 |issue=4 |pages=1117–35 |year=2004 |pmid=15256633 |doi=10.1148/rg.244035149 |url=}}</ref>
*[[Ultrasound]] can help distinguish between cholangitis and [[cholecystitis]] (inflammation of the gallbladder), which has similar symptoms to cholangitis, but appears differently on ultrasound.<ref name="pmid10650107">{{cite journal |vauthors=Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ |title=Diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis |journal=Clin Radiol |volume=55 |issue=1 |pages=25–35 |year=2000 |pmid=10650107 |doi=10.1053/crad.1999.0319 |url=}}</ref>
*Ultrasound can help distinguish between cholangitis and [[cholecystitis]] (inflammation of the gallbladder), which has similar symptoms to cholangitis, but appears differently on ultrasound.<ref name="pmid10650107">{{cite journal |vauthors=Varghese JC, Liddell RP, Farrell MA, Murray FE, Osborne DH, Lee MJ |title=Diagnostic accuracy of magnetic resonance cholangiopancreatography and ultrasound compared with direct cholangiography in the detection of choledocholithiasis |journal=Clin Radiol |volume=55 |issue=1 |pages=25–35 |year=2000 |pmid=10650107 |doi=10.1053/crad.1999.0319 |url=}}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 20:55, 29 July 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2],Farwa Haideri [3]

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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]

  • 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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