Imaging the liver and biliary tract

Several imaging modalities are used to investigate the liver and biliary tract. The commonest is ultrasound, which is safe, cheap and readily available. It is often used as a screening modality. Computed tomography or magnetic resonance imaging or both are often the next modalities of choice, and are used to explore any unusual findings detected on ultrasound. Fluoroscopic imaging procedures, such as percutaneous cholangiography and endoscopic retrograde cholangiopancreatography, are often used when intervention is required, usually for therapeutic reasons.In this article, we describe the role of the each of these imaging modalities in benign and malignant hepatobiliary disease, summarize their use in commonly encountered conditions, such as gallstones, cirrhosis and focal liver lesions, and delineate their advantages and disadvantages. Often, a combination of different modalities is required to reach the final diagnosis. We also describe the complementary role of other less commonly used modalities.