Cholangiocarcinoma other imaging findings: Difference between revisions

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{{Cholangiocarcinoma}}
{{Cholangiocarcinoma}}
{{CMG}};{{AE}} {{PSK}}
{{CMG}}; {{AE}}{{F.K}} [mailto:fkahe@bidmc.harvard.edu], {{PSK}}
==Overview==
==Overview==
Other imaging studies for cholangiocarcinoma include [[endoscopic retrograde cholangiopancreatography]], [[endoscopic ultrasound]], [[percutaneous transhepatic cholangiography]], and [[MRCP]].
Other imaging studies for cholangiocarcinoma include [[endoscopic retrograde cholangiopancreatography]], [[endoscopic ultrasound]], [[percutaneous transhepatic cholangiography]], and [[MRCP]].


===ERCP===
==Other Imaging Findings==
While abdominal imaging can be useful in the diagnosis of cholangiocarcinoma, direct imaging of the [[bile duct]] is often necessary. [[Endoscopic retrograde cholangiopancreatography]] (ERCP) has been widely used for this purpose. Although ERCP is an invasive procedure with attendant risks, its advantages include:
*Other imaging studies for cholangiocarcinoma include [[ERCP]], [[endoscopic ultrasound]], [[percutaneous transhepatic cholangiography]], and [[MRCP]].
*Determine if there is a bile duct tumor and obtain a biopsy to look for cancer cells
 
*Observe if cancer has spread from the bile ducts
===[[Endoscopic retrograde cholangiopancreatography]] (ERCP)===
*Help plan surgery
While abdominal imaging can be useful in the diagnosis of cholangiocarcinoma, direct imaging of the [[bile duct]] is often necessary. [[Endoscopic retrograde cholangiopancreatography]] ([[Endoscopic retrograde cholangiopancreatography|ERCP]]) has been widely used for this purpose. Although [[Endoscopic retrograde cholangiopancreatography|ERCP]] is an invasive procedure with attendant risks, its advantages include:
*Evaluating the [[bile duct]]
*Obtaining a biopsy  
*Helping for plan surgery
*Place a small tube (stent) into the bile duct to relieve a blockage caused by a tumor
*Place a small tube (stent) into the bile duct to relieve a blockage caused by a tumor
[[Image:ERCP cholangioca.jpg|thumb|left|[[ERCP]] image of cholangiocarcinoma, showing common bile duct stricture and dilation of the proximal common bile duct]] <br clear="left" />


===Endoscopic Ultrasound===
===Endoscopic Ultrasound===
*Performed at the time of ERCP  
*Performed at the time of [[Endoscopic retrograde cholangiopancreatography|ERCP]]
*Increase the accuracy of the biopsy and yield information on [[lymph node]] invasion and operability <ref>{{cite journal |author=Sugiyama M, Hagi H, Atomi Y, Saito M |title=Diagnosis of portal venous invasion by pancreatobiliary carcinoma: value of endoscopic ultrasonography |journal=Abdom Imaging |volume=22 |issue=4 |pages=434-8 |year= |id=PMID 9157867}}</ref>
*Increase the accuracy of the biopsy and yield information on [[lymph node]] invasion and operability <ref>{{cite journal |author=Sugiyama M, Hagi H, Atomi Y, Saito M |title=Diagnosis of portal venous invasion by pancreatobiliary carcinoma: value of endoscopic ultrasonography |journal=Abdom Imaging |volume=22 |issue=4 |pages=434-8 |year= |id=PMID 9157867}}</ref>
{{#ev:youtube|P1XCb_B0_vU|500}}


===Percutaneous Transhepatic Cholangiography (PTC)===
===Percutaneous Transhepatic Cholangiography (PTC)===
*Alternative technique for ERCP
*Alternative technique for [[Endoscopic retrograde cholangiopancreatography|ERCP]]


===Direct Cholangiography===
===Direct Cholangiography===
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===[[Magnetic resonance cholangiopancreatography]] (MRCP)===
===[[Magnetic resonance cholangiopancreatography]] (MRCP)===
*[[Non-invasive]] alternative to ERCP.<ref>{{cite journal |author=Schwartz L, Coakley F, Sun Y, Blumgart L, Fong Y, Panicek D |title=Neoplastic pancreaticobiliary duct obstruction: evaluation with breath-hold MR cholangiopancreatography |journal=AJR Am J Roentgenol |volume=170 |issue=6 |pages=1491–5 |year=1998 |id=PMID 9609160}}</ref>
*[[Non-invasive]] alternative to [[Endoscopic retrograde cholangiopancreatography|ERCP]].<ref>{{cite journal |author=Schwartz L, Coakley F, Sun Y, Blumgart L, Fong Y, Panicek D |title=Neoplastic pancreaticobiliary duct obstruction: evaluation with breath-hold MR cholangiopancreatography |journal=AJR Am J Roentgenol |volume=170 |issue=6 |pages=1491–5 |year=1998 |id=PMID 9609160}}</ref>
*More accurately define the tumor and avoids the risks of ERCP <ref>{{cite journal |author=Yeh T, Jan Y, Tseng J, Chiu C, Chen T, Hwang T, Chen M |title=Malignant perihilar biliary obstruction: magnetic resonance cholangiopancreatographic findings |journal=Am J Gastroenterol |volume=95 |issue=2 |pages=432-40 |year=2000 |id=PMID 10685746}}</ref><ref>{{cite journal |author=Freeman M, Sielaff T |title=A modern approach to malignant hilar biliary obstruction |journal=Rev Gastroenterol Disord |volume=3 |issue=4 |pages=187–201 |year=2003 |id=PMID 14668691}}</ref>
*More accurately define the tumor and avoids the risks of [[Endoscopic retrograde cholangiopancreatography|ERCP]] <ref>{{cite journal |author=Yeh T, Jan Y, Tseng J, Chiu C, Chen T, Hwang T, Chen M |title=Malignant perihilar biliary obstruction: magnetic resonance cholangiopancreatographic findings |journal=Am J Gastroenterol |volume=95 |issue=2 |pages=432-40 |year=2000 |id=PMID 10685746}}</ref><ref>{{cite journal |author=Freeman M, Sielaff T |title=A modern approach to malignant hilar biliary obstruction |journal=Rev Gastroenterol Disord |volume=3 |issue=4 |pages=187–201 |year=2003 |id=PMID 14668691}}</ref>


==References==
==References==

Latest revision as of 16:32, 13 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2] [3], Suveenkrishna Pothuru, M.B,B.S. [4]

Overview

Other imaging studies for cholangiocarcinoma include endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, percutaneous transhepatic cholangiography, and MRCP.

Other Imaging Findings

Endoscopic retrograde cholangiopancreatography (ERCP)

While abdominal imaging can be useful in the diagnosis of cholangiocarcinoma, direct imaging of the bile duct is often necessary. Endoscopic retrograde cholangiopancreatography (ERCP) has been widely used for this purpose. Although ERCP is an invasive procedure with attendant risks, its advantages include:

  • Evaluating the bile duct
  • Obtaining a biopsy
  • Helping for plan surgery
  • Place a small tube (stent) into the bile duct to relieve a blockage caused by a tumor

Endoscopic Ultrasound

  • Performed at the time of ERCP
  • Increase the accuracy of the biopsy and yield information on lymph node invasion and operability [1]

{{#ev:youtube|P1XCb_B0_vU|500}}

Percutaneous Transhepatic Cholangiography (PTC)

  • Alternative technique for ERCP

Direct Cholangiography

  • Evaluation of the the biliary tree
  • Planning treatment as assessing for resectability

Magnetic resonance cholangiopancreatography (MRCP)

References

  1. Sugiyama M, Hagi H, Atomi Y, Saito M. "Diagnosis of portal venous invasion by pancreatobiliary carcinoma: value of endoscopic ultrasonography". Abdom Imaging. 22 (4): 434–8. PMID 9157867.
  2. Schwartz L, Coakley F, Sun Y, Blumgart L, Fong Y, Panicek D (1998). "Neoplastic pancreaticobiliary duct obstruction: evaluation with breath-hold MR cholangiopancreatography". AJR Am J Roentgenol. 170 (6): 1491–5. PMID 9609160.
  3. Yeh T, Jan Y, Tseng J, Chiu C, Chen T, Hwang T, Chen M (2000). "Malignant perihilar biliary obstruction: magnetic resonance cholangiopancreatographic findings". Am J Gastroenterol. 95 (2): 432–40. PMID 10685746.
  4. Freeman M, Sielaff T (2003). "A modern approach to malignant hilar biliary obstruction". Rev Gastroenterol Disord. 3 (4): 187–201. PMID 14668691.

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