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Cholangiography
Last reviewed: 23.04.2024
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Cholangiography is a group of methods for radiologic examination of the biliary tract after direct introduction of a contrast agent into their lumen. Cholangiography is not associated with liver cells and the concentration capacity of the gallbladder. Contrast substance can be administered by different routes: percutaneous puncture into bile ducts or gallbladder (percutaneous transhepatic cholangiography or percutaneous cholecystography); under the control of duodenoscopy in the hole of the large papilla of the duodenum (endoscopic retrograde cholangiopancreatography - ERCPG); during surgical intervention (intraoperative cholangiography) or in the postoperative period through the drainage tube. Recently, magnetic resonance cholangiography has been developing rapidly and successfully. The main purpose of cholangiography is the investigation of the biliary tract in patients with mechanical (subhepatic) jaundice of various etiologies. It is performed after sonography and computed tomography.
Image of the liver and biliary tract can be obtained using radionuclide methods. For this, the patient is intravenously injected with RFP, which is captured from the blood either by hepatocytes ( 99m Tc-butyl-IDA) or by stellate reticuloendotheliocytes ( 99m Tc-colloid). In the first case, the technique is called hepatobiliary scintigraphy, in the second - hepatoscintigraphy. In both cases, a picture of the liver appears on the scintigrams. In the direct projection, it has the form of a large triangle; in it it is possible to distinguish between the right and left lobes, a depression from above (cardiac notch), sometimes a notch along the lower contour, respectively, in the pit of the gallbladder. The density of the shadow is higher in the central part of the right lobe, since there is more volume of hepatic tissue. In the lateral projection, the shadow of the liver looks like a wrong oval, a rhombus or a triangle. In all positions, a uniform distribution of RFP in the organ is recorded.
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