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CT cholangiography

CT cholangiography is a technique of imaging the biliary tree with the usage of hepatobiliary excreted contrast. It is useful in delineating biliary anatomy, identifying a bile leak or looking for retained gallstones within the biliary system.

Second-line test (after ultrasound) when investigating for right upper quadrant pain, obstructive LFTs, etc. It can also be used in the postoperative setting (e.g. post cholecystectomy) where there is a concern for common bile duct injury or retained gallstones, or where intraoperative cholangiography (IOC) was unable to be performed due to extensive inflammation or a narrow cystic duct, proving direct cannulation difficult.

  • bilirubin should be < 30 mmol/L nor should it be rising rapidly (as the impaired excretory ability of hepatocytes can affect contrast excretion in bile) 
  • severe hepatic or renal dysfunction
  • thyroid dysfunction
  • iodinated-contrast hypersensitivity or allergy

CT cholangiography may be performed with either intravenous or oral cholangiographic contrast agents both of which outline the biliary tree with positive contrast. 

Occasionally vicarious contrast material excretion can give opacification of the gallbladder and biliary system

CT examinations

Article information

rID: 35600
Synonyms or Alternate Spellings:
  • CT cholangiogram
  • CT intravenous cholangiograms (CT IVC)
  • CT intravenous cholangiography (CT IVC)

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Cases and figures

  • Case 1: normal CT cholangiogram
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  • Case 2
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  • Case 3
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  • Case 4
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  • Case 5
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  • Case 6: obstructive choledocolithiasis
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  • Case 7: traumatic bile leak
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