Radiology, Vol 153, 755-756, Copyright © 1984 by Radiological Society of North America
CT evaluation of the bile ducts in patients with fatty liver
LE Quint and GM Glazer
Computed tomographic (CT) evaluation of the bile ducts in the fatty liver
can be difficult, since hepatic attenuation decreases with increased
triglyceride content, and liver parenchyma may become isodense with bile.
Forty-seven patients with fatty infiltration of the liver were
retrospectively identified. In 7 of these patients, attenuation of liver
and bile differed by less than 10 HU. In 2 patients, dilated intrahepatic
ducts were invisible using CT, because bile was isodense with fatty liver
parenchyma. Thus, the fatty liver presents a potential pitfall in CT
evaluation of the bile ducts. Obstructive jaundice can be diagnosed in
patients with fatty liver, if the extrahepatic ducts and peribiliary
vascular plexus region are carefully scrutinized. For maximal accuracy,
scans should be obtained both before and after administration of
intravenous urographic contrast material.
