Vicarious Excretion

High-density material within gallbladder (GB)

– CT > 10x more sensitive than radiographs in detecting slight differences in density

– Mild to moderate opacification of GB bile on day after CECT or angiogram is a normal and expected finding

Does not necessarily imply abnormal renal function

– Dense opacification on CT indicates ↓ renal function

Increased attenuation of ascites fluid

– Visible a few hours after IV administration of contrast

– Results from hepatobiliary and peritoneal contrast excretion into ascites

– Mildly increased density of ascites fluid may not indicate renal impairment

– Significantly ↑ attenuation suggests ↓ renal function

Increased attenuation of pericardial fluid

– Most common in first few hours after IV contrast

– Mildly ↑ attenuation can be normal finding

• Radiographic findings

Opacification of bile within GB after IV contrast always implies impaired or delayed renal function

Mild to moderate vicarious excretion is visible on CT in normal patients, but is insufficient to be visible on radiographs

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Nov 16, 2016 | Posted by admin in GASTROINTESTINAL IMAGING | Comments Off