Intravenous cholangiography is a form of

cholangiography Cholangiography is the imaging of the bile duct (also known as the biliary tree) by x-rays and an injection of contrast medium. __TOC__ Types There are at least four types of cholangiography: # Percutaneous transhepatic cholangiography (PTC): Exam ...

that was introduced in 1954.

Overview

The intravenous cholangiogram or IVC is a radiologic (x-ray) procedure that is used primarily to look at the larger

bile duct A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. Bile is required for the digestion of food and is secreted by the liver into passages that carry bile toward the hepatic duct. It ...

s within the liver and the bile ducts outside the liver. The procedure can be used to locate

gallstone A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of ...

s within these bile ducts. IVC also can be used to identify other causes of obstruction to the flow of bile, for example, narrowings (strictures) of the bile ducts and cancers that may impair the normal flow of bile.

Procedure

To do an IVC, an iodine-containing dye (meglumine ioglycamate) is injected intravenously into the blood. The liver then removes the dye from the blood and excretes it into the bile. The iodine is sufficiently concentrated as it is secreted into the bile that it does not need to be further concentrated by the

gallbladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, althoug ...

to outline the bile ducts and any gallstones that may be there. The gallbladder is not always seen on an IVC, as the iodine-containing bile may bypass the gallbladder entirely and empty directly into the

small intestine The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through t ...

Risks

Occasional serious allergic reactions can occur to any iodine-containing dye. These reactions can usually be treated and rarely result in death.

Indications

The IVC is not used as much today as it was. Its use always was limited, because it did not work when there was more than a minimal amount of

jaundice Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme met ...

, and many of the conditions it was used to detect also caused substantial jaundice. The IVC has been largely replaced by other diagnostic procedures—by ERCP (

endoscopic retrograde cholangiopancreatography Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly sk ...

endoscopic ultrasound Endoscopic ultrasound (EUS) or echo-endoscopy is a medical procedure in which endoscopy (insertion of a probe into a hollow organ) is combined with ultrasound to obtain images of the internal organs in the chest, abdomen and colon. It can be used t ...

and, increasingly, by MRI cholangiography, none of which are affected by jaundice. It is sometimes used when ERCP is unsuccessful.

References

{{Medical imaging Projectional radiography Hepatology Digestive system imaging