Clinical application of three-dimensional sonography in hepatobiliary disease

The diagnostic value of a novel three-dimensional (3D) ultrasound method was analyzed in 93 patients with chronic liver disease, and was compared with conventional 2D sonography. In 26 of 93 patients (28%) 3D sonography was superior to 2D sonography. 3D sonography improved the assessment of the extent and localization of liver tumors (9/20). In 2 of 5 Budd Chiari patients 3D sonography refined the visualization of vascular thrombi. Correct detection of the number of gallstones and their localization within the biliary tree was enhanced by 3D sonography (8/16), especially in cases of cystic duct and prepapillary stones. The assessment of the extent of biliary tract alterations in primary sclerosing cholangitis was superior in 3D sonography (4/7). In contrast, 3D imaging did not add important information in diffuse liver disease. Our results indicate that 3D imaging is superior to routine sonography in the anatomical assignment of complex vascular and biliary duct alterations, while there is no obvious benefit in diffuse liver disease so far.