What imaging studies are useful in the diagnosis of gallstones (cholelithiasis)?

Updated: Apr 01, 2019
  • Author: Douglas M Heuman, MD, FACP, FACG, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Imaging modalities that may be useful include the following:

  • Abdominal radiography (upright and supine) – Used primarily to exclude other causes of abdominal pain (eg, intestinal obstruction)

  • Ultrasonography – The procedure of choice in suspected gallbladder or biliary disease

  • Endoscopic ultrasonography (EUS) – An accurate and relatively noninvasive means of identifying stones in the distal CBD

  • Laparoscopic ultrasonography – Promising as a potential method for bile duct imaging during laparoscopic cholecystectomy

  • Computed tomography (CT) – More expensive and less sensitive than ultrasonography for detecting gallbladder stones, but superior for demonstrating stones in the distal CBD

  • Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) – Usually reserved for cases in which choledocholithiasis is suspected

  • Scintigraphy – Highly accurate for the diagnosis of cystic duct obstruction

  • Endoscopic retrograde cholangiopancreatography (ERCP)

  • Percutaneous transhepatic cholangiography (PTC)

See Workup for more detail.


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