Diagnostic Ultrasound - Abdomen and Pelvis

Intrahepatic and Extrahepatic Duct Dilatation
Recurrent Pyogenic Cholangitis
Cholangiocarcinoma
(Left) Grayscale US of the liver
shows a large intrahepatic
stone causing upstream
biliary ductal dilatation st in a
patient with recurrent
pyogenic cholangitis. (Right)
Transverse color Doppler US of
the left lobe of the liver shows
moderate biliary ductal
dilatation st caused by an
obstructing central
cholangiocarcinoma.
Differential Diagnoses: Biliary System
Cholangiocarcinoma
Choledochal Cyst
(Left) Longitudinal oblique US
of the common bile duct
demonstrates an obstructing
soft tissue mass , which was
proven to represent an
intraluminal
cholangiocarcinoma. (Right)
Longitudinal oblique US of the
right upper quadrant in a 14-
year-old girl shows a markedly
dilated tubular structure ,
which was found to be a large
type I choledochal cyst.
Biliary Intraductal Papillary Mucinous
Neoplasm
Biliary Intraductal Papillary Mucinous
Neoplasm
(Left) Transverse US of the
liver shows moderate
intrahepatic ductal dilatation
ſt, which was caused by a
biliary intraductal papillary
mucinous neoplasm. Biliary
ductal dilatation was seen
both proximal as well as distal
to the lesion due to copious
mucin production. (Right)
Intraoperative grayscale
ultrasound in the same patient
shows the biliary intraductal
papillary neoplasm has frondlike
projections into the
biliary tree. The point where
the biliary IPMN arises from
the biliary duct wall is
evident on this image.
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