LESSON 12
DIAGNOSTIC RADIOLOGY OF HEPATOBILIARY SYSTEM AND
PANCREAS
PLAIN RADIOGRAPHY
Plain radiographs are of limited value for assessing the liver, but can demonstrate
gross hepatomegaly and hepatic calcification. The complex shape of the liver,
limited soft-tissue contrast and projection acquisition of plain radiographs makes
identification of liver boundaries difficult. The true borders of the normal liver can
only be identified if directly outlined by fat or by free intraperitoneal air. In the
normal patient the lungs and intervening diaphragm delineate the apparent superior
liver border. Properitoneal fat usually correctly delineates the true lateral border of
the right lobe.Contrast radiography of biliary ducts - cholangiography is usefull
after surgical procedures of gallblader.
ULTRASOUND
Abdominal US is mainly performed with transducers operating between 3 and 5
MHz. Doppler capability, both spectral and colour, has now become an integral
part of the examination of the liver, allowing demonstration of hepatic blood flow.
Doppler examination of the hepatic vessels can be performed relatively rapidly
and is becoming part of the routine US examination of the liver. On ultrasound
Gallstones visualized such as hyperechoic shadow and acoustic road reflected from
the stone. Chronic cholecystitis on ultrasound is visible as thickening of the walls
of the gallbladder Acute pancreatitis on ultrasound is visible as inhomogeneous
structure, but in chronic pancreatitis on ultrasound stones are observed in the
parenchyma.
Tumor of the pancreatic head with sonography appears as a rough homogeneous
field with fuzzy contours. When enlarging, it gives a dilation of the portal vein and
DIAGNOSTIC RADIOLOGY OF HEPATOBILIARY SYSTEM AND
PANCREAS
PLAIN RADIOGRAPHY
Plain radiographs are of limited value for assessing the liver, but can demonstrate
gross hepatomegaly and hepatic calcification. The complex shape of the liver,
limited soft-tissue contrast and projection acquisition of plain radiographs makes
identification of liver boundaries difficult. The true borders of the normal liver can
only be identified if directly outlined by fat or by free intraperitoneal air. In the
normal patient the lungs and intervening diaphragm delineate the apparent superior
liver border. Properitoneal fat usually correctly delineates the true lateral border of
the right lobe.Contrast radiography of biliary ducts - cholangiography is usefull
after surgical procedures of gallblader.
ULTRASOUND
Abdominal US is mainly performed with transducers operating between 3 and 5
MHz. Doppler capability, both spectral and colour, has now become an integral
part of the examination of the liver, allowing demonstration of hepatic blood flow.
Doppler examination of the hepatic vessels can be performed relatively rapidly
and is becoming part of the routine US examination of the liver. On ultrasound
Gallstones visualized such as hyperechoic shadow and acoustic road reflected from
the stone. Chronic cholecystitis on ultrasound is visible as thickening of the walls
of the gallbladder Acute pancreatitis on ultrasound is visible as inhomogeneous
structure, but in chronic pancreatitis on ultrasound stones are observed in the
parenchyma.
Tumor of the pancreatic head with sonography appears as a rough homogeneous
field with fuzzy contours. When enlarging, it gives a dilation of the portal vein and
