Radiographic diagnosis of bile duct cysts. Retrospective analysis of thirteen cases.

Twelve patients and a foetus with congenital bile duct cysts suggested in the majority of cases at routine upper abdominal sonography were examined by two or more of the following investigations: ultrasonography (10 patients), computed tomography (5 patients), CT-cholangiography (2 patients), oral cholecystography (7 patients), intravenous cholangiography (4 patients), endoscopic retrograde cholangiopancreatography (ERCP) (6 patients) and cholescintigraphy (2 patients). The sensitivity of each investigation for the diagnosis of bile duct cysts was: ultrasound 40 per cent, computed tomography 20 per cent, CT-cholangiography 100 per cent, oral cholecystography 17 per cent, intravenous cholangiography 75 per cent, ERCP 83 per cent and cholescintigraphy 50 per cent. When a bile duct cyst has been suggested by ultrasonography or other examinations, without a conclusive diagnosis being made, CT-cholangiography is recommended as the next examination. In patients with impaired biliary excretion of contrast medium, ERCP may be required to achieve the diagnosis.