CT Abdomen and Pelvis With IV Contrast CT abdomen with IV contrast can be used to look for morphologic changes of chronic liver parenchymal disease and its complications. CT can help identify the site of obstruction and the potential etiologies. MRI with MRCP is superior to evaluate the biliary system. Malignant biliary strictures can be identified with a high sensitivity (95%), specificity (93.35%), and accuracy (88.5%) on CT [79]. Abnormal Liver Function Tests CT abdomen with IV contrast is very accurate for diagnosis and staging of pancreaticobiliary malignancies, which can present with hyperbilirubinemia. Tumor resectability and surgical planning for both pancreatic and biliary cancers can be done using CT. There are advantages to including the pelvis in the CT abdomen and pelvis examination, including detecting lymphadenopathy and pelvic ascites. CT Abdomen and Pelvis Without and With IV Contrast CT of the abdomen and pelvis with and without IV contrast is not typically useful for this clinical scenario because there is no benefit from adding unenhanced images. CT Abdomen and Pelvis Without IV Contrast Unenhanced CT has limited utility in assessing biliary obstruction (including etiologies) and liver fibrosis. MRI Abdomen with MRCP As discussed in Variant 3 above, MRI with MRCP is the most useful for evaluating the etiology of biliary obstruction. Contrast is helpful to look for cholangitis and assess malignant etiologies of biliary obstruction. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation. For additional information on the Appropriateness Criteria methodology and other supporting documents go to www. acr.org/ac. Abnormal Liver Function Tests 12 2.
Abnormal Liver Function Tests. CT Abdomen and Pelvis With IV Contrast CT abdomen with IV contrast can be used to look for morphologic changes of chronic liver parenchymal disease and its complications. CT can help identify the site of obstruction and the potential etiologies. MRI with MRCP is superior to evaluate the biliary system. Malignant biliary strictures can be identified with a high sensitivity (95%), specificity (93.35%), and accuracy (88.5%) on CT [79]. Abnormal Liver Function Tests CT abdomen with IV contrast is very accurate for diagnosis and staging of pancreaticobiliary malignancies, which can present with hyperbilirubinemia. Tumor resectability and surgical planning for both pancreatic and biliary cancers can be done using CT. There are advantages to including the pelvis in the CT abdomen and pelvis examination, including detecting lymphadenopathy and pelvic ascites. CT Abdomen and Pelvis Without and With IV Contrast CT of the abdomen and pelvis with and without IV contrast is not typically useful for this clinical scenario because there is no benefit from adding unenhanced images. CT Abdomen and Pelvis Without IV Contrast Unenhanced CT has limited utility in assessing biliary obstruction (including etiologies) and liver fibrosis. MRI Abdomen with MRCP As discussed in Variant 3 above, MRI with MRCP is the most useful for evaluating the etiology of biliary obstruction. Contrast is helpful to look for cholangitis and assess malignant etiologies of biliary obstruction. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation. For additional information on the Appropriateness Criteria methodology and other supporting documents go to www. acr.org/ac. Abnormal Liver Function Tests 12 2.