title: Of cholescintigraphy, sonography, and great bears. A view on modern biliary imaging.
abstract: We review the discrepancies and the reasons for them, in two articles in this issue of the Journal to conclude that clinical findings hold the key to selection of the proper imaging test in biliary obstruction. Cholescintigraphy is a more rewarding approach in detecting low grade obstruction, as by common duct stones, whereas in the patient with prolonged painless jaundice, and the high likelihood of a malignancy, computed tomography or ultrasound will yield the best results. Because of the potential for noninvasive imaging to miss choledocholithiasis and because of ever increasing therapeutic options, direct cholangiography will continue to be the mainstay in definition evaluation of the biliary tract.
mesh_terms: D002779:Cholestasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D006801:Humans; D007098:Imino Acids; D009942:Organometallic Compounds; D011877:Radionuclide Imaging; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid; D019785:Technetium Tc 99m Disofenin; D014463:Ultrasonography
chemical_list: D007098:Imino Acids; D009942:Organometallic Compounds; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid; D019785:Technetium Tc 99m Disofenin