Mastering Biliary Tree Imaging

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Questions and Answers

What is the recommended imaging technique to demonstrate the biliary system, according to the text?

MRI

Ultrasound imaging (correct)

CT scan

X-ray

What is the purpose of taking plain radiographs of the biliary system, according to the text?

To assess the function of the biliary system

To demonstrate opacities in the region of the gallbladder and biliary tree (correct)

To visualize the biliary system

To diagnose biliary system diseases

What is the recommended patient preparation for biliary system imaging, according to the text?

Taking laxatives and a diet to clear overlying faeces and bowel gas (correct)

Taking pain medication

Drinking plenty of water

Fasting for 24 hours

What is the purpose of immobilization in radiography?

To prevent motion artifacts (C) Signup and view all the answers

What is the recommended kilovoltage for this radiographic image?

70 kVp (C) Signup and view all the answers

What is the position of the patient for this radiographic image?

Prone (A) Signup and view all the answers

What is the purpose of collimation in radiography?

To improve the sharpness of the image (D) Signup and view all the answers

What is the recommended mAs for this radiographic image?

Short exposure time with high mA (B) Signup and view all the answers

What position should the patient be in during the procedure?

Supine (B) Signup and view all the answers

What should be done with the T-tube prior to insertion?

It should be raised and tapped to remove air bubbles (B) Signup and view all the answers

What is the purpose of obtaining an early filling image?

To assess the patency of the biliary tree (D) Signup and view all the answers

What should be done for immunosuppressed patients prior to the procedure?

Prophylactic dose of broad spectrum antibiotic (D) Signup and view all the answers

What is the purpose of the control image of the RUQ?

To assess the patency of the biliary tree (B) Signup and view all the answers

What is the purpose of taking a laxative for two days prior to the examination days in this technique?

To evaluate the laxative preparation (B) Signup and view all the answers

What is the purpose of the single control radiograph of the whole abdomen or the right side of the abdomen in this technique?

To judge the exposure for the second part of the examination (D) Signup and view all the answers

How long before the examination should the patient take the oral contrast (Biloptin)?

14 hours (A) Signup and view all the answers

What substance is used as the oral contrast in this technique?

Iodine-containing substance (Biloptin) (C) Signup and view all the answers

What should the patient avoid prior to the examination in this technique?

Smelling food (B) Signup and view all the answers

What is a potential complication of persistent biliary fistula according to the text?

Biliary peritonitis (C) Signup and view all the answers

What is the consequence of not treating a biliary fistula?

Gastric ulceration (C) Signup and view all the answers

What is the treatment for cholangitis according to the text?

Antibiotics (A) Signup and view all the answers

What is the cause of biliary peritonitis according to the text?

Leakage of bile into the peritoneal cavity (C) Signup and view all the answers

What is the consequence of delayed treatment of cholangitis according to the text?

Hepatic necrosis (D) Signup and view all the answers

What is the recommended direction of the vertical central ray for imaging in the described procedure?

Directed to a point 7.5 cm to the right of the spinous processes (D) Signup and view all the answers

What is the recommended position for the patient's respiration for the described procedure?

Arrested respiration after full expiration (D) Signup and view all the answers

What is the primary purpose of an Oral Cholecystogram (O.C.G)?

To examine the gall bladder, billiary and cystic duct (A) Signup and view all the answers

What is a contraindication for an Oral Cholecystogram (O.C.G)?

Abnormality in oesophagus (D) Signup and view all the answers

What is the recommended number of views of the entire biliary tree that should be recorded by spot film during injection of contrast medium to the duodenum?

At least 2 views (A) Signup and view all the answers

What are some indications for imaging an Oral Cholecystogram (O.C.G)?

Lazy gallbladder, atonic GB, GB stone, multiple diverticulum of the GB (C) Signup and view all the answers

What should be done if the intrahepatic ducts do not fill during injection of contrast medium to the duodenum?

The patient should be tilted trendelenburg and further contrast injected (A) Signup and view all the answers

What position should the patient be in to fill the left hepatic duct during injection of contrast medium to the duodenum?

Left side (D) Signup and view all the answers

What should be checked for 24 hours if the T-tube is removed after the procedure?

The patient's wound for bile leakage (A) Signup and view all the answers

What should the patient be warned to advise of post procedure?

Any itching or rash (B) Signup and view all the answers

What is the ideal position for the patient during the typical film sequence for gall bladder imaging?

Left anterior oblique position (D) Signup and view all the answers

What is the purpose of the fatty meal given to the patient during the imaging process?

To provide contrast for the images (C) Signup and view all the answers

What is the recommended time frame for the patient to take the tablets before the examination?

4 hours before the examination (D) Signup and view all the answers

Which image projection best demonstrates the gall bladder in the first two films?

LAO position image (D) Signup and view all the answers

What is the main reason for imaging the gall bladder region?

To detect gallstones or other gall bladder issues (B) Signup and view all the answers

What is a common complication associated with the administration of SAR?

Urticarial skin reactions (B) Signup and view all the answers

What is the purpose of a T-tube cholangiogram?

To inject contrast medium into the biliary tree (C) Signup and view all the answers

When is a T-tube most commonly inserted?

During a cholecystectomy operation (B) Signup and view all the answers

What is the main function of the T-tube in a cholangiogram procedure?

To allow injection of contrast medium into the biliary tree (D) Signup and view all the answers

What is a rare complication associated with the administration of SAR?

Vasodilation (D) Signup and view all the answers

What is the main indication for performing a cholangiography procedure?

To diagnose obstructive jaundice (C) Signup and view all the answers

What is a contraindication for cholangiography procedure?

Contrast or iodine allergy (C) Signup and view all the answers

What is the preparation step required before performing a cholangiography procedure?

Patient identification (A) Signup and view all the answers

What is a possible complication of cholangiography procedure?

Contrast-induced nephropathy (A) Signup and view all the answers

What is the contraindication related to barium study for cholangiography procedure?

Barium study within last 3 days (D) Signup and view all the answers

Study Notes

Biliary System Imaging

Recommended imaging technique to demonstrate the biliary system: Oral Cholecystogram (O.C.G)
Purpose of taking plain radiographs of the biliary system: To identify abnormalities in the system

Patient Preparation

Recommended patient preparation: 2-day laxative preparation to cleanse the bowel, avoiding food and drinks 12 hours prior to the examination
Patient should take the oral contrast (Biloptin) 2 hours before the examination

Radiographic Image

Recommended kilovoltage: Not specified
Recommended patient position: Erect or supine position, depending on the procedure
Purpose of collimation: To reduce scattered radiation and improve image quality
Recommended mAs: Not specified

T-tube Cholangiogram

Purpose of the T-tube: To drain bile from the common bile duct
T-tube is most commonly inserted: After a surgical procedure
Main function of the T-tube: To drain bile and allow for cholangiography
Prior to insertion: The T-tube should be flushed and checked for patency

Immobilization and Collimation

Purpose of immobilization: To reduce patient movement and improve image quality
Purpose of collimation: To reduce scattered radiation and improve image quality

Procedure

Patient position during the procedure: Erect or supine position, depending on the procedure
Recommended direction of the vertical central ray: Not specified
Recommended patient respiration: Held breath during the exposure

Indications and Contraindications

Primary purpose of an Oral Cholecystogram (O.C.G): To evaluate the gallbladder and bile ducts
Contraindication for an Oral Cholecystogram (O.C.G): Liver or gallbladder disease
Indications for imaging an Oral Cholecystogram (O.C.G): Suspected gallbladder disease or obstruction
Contraindication for cholangiography procedure: Barium study, liver or gallbladder disease

Complications

Possible complication of cholangiography procedure: Biliary fistula or peritonitis
Rare complication associated with the administration of SAR: Anaphylaxis
Common complication associated with the administration of SAR: Nausea and vomiting

Treatment

Treatment for cholangitis: Antibiotics and drainage
Consequence of delayed treatment of cholangitis: Sepsis and death
Treatment for biliary fistula: Drainage and surgical repair

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Description

Test Your Knowledge on Biliary Tree Imaging Techniques: Learn about the essential steps and tips for successful imaging of the biliary tree. This quiz covers important aspects such as contrast injection, patient positioning, and imaging views. Sharpen your skills and enhance your expertise in biliary tree imaging with this informative quiz.