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): Ex ...

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. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior). Bile is requ ...

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 Meglumine is a sugar alcohol derived from glucose that contains an amino group modification. It is often used as an excipient in pharmaceuticals and in conjunction with iodinated compounds in contrast media A contrast agent (or contrast medium ...

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 (anatomy), organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath t ...

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 (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...

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, less frequently, 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 ...

, 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 An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior ...

), endoscopic ultrasound and, increasingly, by

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...

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