Carcinoma of the Gallblader and Biliary Ducts -What Is the Value of CT, MRI, and Magnetic Resonance Cholangiography?Diagnostic imaging of the hepatobiliary system represents one of the most challenging tasks in radiology. Complex anatomical conditions as well as unavoidable motion artifacts due to breathing and peristalsis hamper the early detection of neoplastic biliary disease. Carcinoma of the gallbladder are the fifth most frequent neoplastic disease of the abdomen. 75% of the patients suffer from gallstones, and about 1% of patients with cholelithiasis develop a gallbladder carcinoma. In most cases, at the time of diagnosis an advanced stage of disease is reached, the 5-year survival rate is below 5%. Clinically, the primary symptom of cholangiocarcinoma is jaundice. On CT and MRI, the disease is associated with a dilation (>10 mm) of the intrahepatic biliary tract. Delineation of the primary tumor, which is in about 50%located at the junction of the hepatic ducts (Klatskin tumor), is difficult. CT facilitates high-resolution imaging of the hepatobiliary system in different phases of contrast enhancement. Furthermore, digital postprocessing allows secondary reformatting of the images in arbitrarily oriented planes. MRI provides better intrinsic soft-tissue contrast. High-resolution T2 images and contrast-enhanced T1-weighted images with fat suppression are best suited for tumor detection. 3D MR cholangiography may replace i.v. cholangiography.

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2004
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