Value of ultrasound in diagnosis of bile duct tumors

Resectability of biliary duct carcinomas depends mainly on the extension of the tumour mass. The value of ultrasonography (US) in demonstrating the tumour itself was compared with computed tomography (CT) and endoscopic retrograde cholangiography (ERCP)/percutaneous cholangiography (PTC) in 84 patients with biliary duct carcinoma (31 tumours of the hilar region, 50 distal tumours and 3 recurrent gallbladder carcinomas). The level of obstruction was correctly indicated by US in 96% of the cases. Correct visualisation by US of the tumour itself was possible in 68% of proximal tumours and 36% with distal tumours. CT accurately detected 74% of proximal and 48% of distal tumours. ERC/PTC identified intraductal tumour growth in all patients. The level of obstruction can be accurately identified by US and CT. The tumour itself cannot be visualised by imaging methods in 25-50% of the cases, depending on the localisation of the tumour.