Helmberger H, Kammer B
Zentrum für Radiologie und Nuklearmedizin Nymphenburg, Klinikum Dritter Orden, Menzingerstr. 44, 80638, München, Deutschland.
Kinderradiologie im Dr. von Haunerschen Kinderspital der Radiologischen Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Deutschland.
Radiologe. 2018 Nov;58(11):1021-1034. doi: 10.1007/s00117-018-0460-y.
Upper abdominal pain, icterus and cholestasis are the main symptoms leading to evaluation of the biliary tract. Since the advent of contrast-enhanced ultrasound techniques the accuracy of bile duct imaging has significantly improved. This is also true for computed tomography using isotropic secondary reconstructions as well as magnetic resonance imaging (MRI) including MR cholangiography (MRC), classically and after iv injection of hepatobiliary contrast agent. Diffusion-weighted imaging sequences have a recently proven ability for improving biliary tract imaging. These technical improvements provide the depiction of the non-dilated biliary tract system in diagnostic quality. Therefore, normal variants and congenital disorders of biliary tract anatomy are delineated as well as insights into the postoperative situs and complications related to surgery. Cholelithiasis is the most frequent disease of the gall bladder and biliary tract. Together with related complications, in the majority of cases it is also the reason for bile duct inflammation. Due to the immediate need for treatment special care has to be taken for hydrops of the gall bladder.
上腹部疼痛、黄疸和胆汁淤积是促使对胆道进行评估的主要症状。自从对比增强超声技术出现以来，胆管成像的准确性有了显著提高。使用各向同性二次重建的计算机断层扫描以及磁共振成像（MRI），包括经典的磁共振胆管造影（MRC）和静脉注射肝胆对比剂后的磁共振成像，情况也是如此。扩散加权成像序列最近已被证明有改善胆道成像的能力。这些技术改进能够以诊断级质量显示未扩张的胆道系统。因此，不仅可以描绘胆道解剖结构的正常变异和先天性疾病，还能深入了解术后位置以及与手术相关的并发症。胆结石是胆囊和胆道最常见的疾病。在大多数情况下，它连同相关并发症也是胆管炎症的原因。由于需要立即治疗，必须特别关注胆囊积水。
