What is the role of CT scanning in the workup of biliary obstruction?

Updated: Oct 16, 2019
  • Author: Jennifer Lynn Bonheur, MD; Chief Editor: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS  more...
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Traditional CT scanning is usually considered more accurate than US for helping determine the specific cause and level of obstruction. In addition, it helps visualize liver structures more consistently than US. The addition of intravenous contrast helps differentiate and define vascular structures and the biliary tract.

CT scanning has limited value in helping diagnose CBD stones because many of them are radiolucent and CT scanning can only image calcified stones. It is also less useful in the diagnosis of cholangitis because the findings that specifically suggest bile duct infection (increased attenuation due to pus, bile duct wall thickening, and gas) are seen infrequently.

Lastly, CT scanning is expensive and involves exposure to radiation, both of which lessen the routine use CT scans compared to US examinations.

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