Imaging Evaluation of the Biliary Tree

Noninvasive visualization of the biliary tree is of paramount importance in any patient who may require a biliary surgical intervention. Most hospitals and imaging centers offer ultrasound, computed tomography (CT), cholescintigraphy (commonly known as hepatobiliary iminodiacetic acid scan), and MRI whenever acute biliary pathology is suspected. PET combined with CT is sometimes utilized to evaluate biliary malignancy and metastatic disease. Unfortunately, these imaging modalities are often ordered incorrectly and have numerous limitations. This article discusses the strengths and weaknesses or each imaging modality and focuses on appropriateness of their utilization in clinical practice.