Imaging of the liver and biliary tree

Recent major technological advances in computed tomography (CT) and magnetic resonance imaging (MRI) have enabled the accurate, non-invasive detection and characterization of hepatic lesions. Due to its relative lower cost, availability, and widespread distribution, CT is often the primary imaging modality in the initial evaluation of the liver. However, with the comparatively superior lesion-to-liver contrast, the ability to utilize hepatocyte-specific contrast agents, and the lack of ionizing radiation, MRI is realizing an increasingly greater role in this regard. For assessment of the gall bladder and biliary system, ultrasound (US) remains a basic modality for the prompt diagnosis of stones and acute inflammatory or obstructing processes. Advanced CT and MR techniques are utilized for evaluating equivocal US findings, oncologic staging, preoperative planning, and postoperative complications. This chapter reviews the discriminating imaging features of commonly encountered hepatobiliary pathology at cross-sectional imaging.