Intravenous Cholangiogram (IVC)

Intravenous cholangiogram (IVC) helps identify obstructions to the bile duct.

Definition of intravenous cholangiogram

The intravenous cholangiogram is a test no longer frequently used. An intravenous cholangiogram is an X-ray taken to image larger bile ducts located both inside and outside the liver. An iodine-based dye is injected into a vein in the arm and is then excreted by the liver into its bile ducts (tubes), allowing them to be seen on X-ray.

The liver makes bile, a fluid that helps in digesting fats in the diet, breaking them down into fatty acids so that they can be absorbed in the small intestine. The hepatic (hepa=liver) bile duct sends the bile to the gallbladder where it is stored. After a meal, the gallbladder contracts and sends the bile to the small intestine through the cystic duct. Just before the cystic duct enters the intestine, it is joined by the pancreatic duct (delivering enzymes from the pancreas) and is renamed the common bile duct.

The intravenous cholangiogram outlines the biliary tree looking for abnormalities. The most common abnormality found is gallstones, which is also the most common reason to order the test. The test can also find other problems, including structures or narrowing of the ducts, or tumors and other masses that can compress a duct.

The intravenous cholangiogram has been replaced by other technologies including:

• Ultrasound
• PTC -- percutaneous transhepatic cholangiography
• ERCP -- endoscopic retrograde cholangiopancreatography
• MRCP -- Magnetic resonance cholangiopancreatography

This is an elective outpatient procedure. Usually, the patient is asked to fast for at least 6 hours prior to the exam. No other preparation is needed.

The test begins with an intravenous line being inserted in the patient’s arm. Once on the X-ray table, an iodine-based dye is injected. Shortly thereafter, X-rays are taken of the right side of the abdomen, where the liver and gallbladder are located.

What is IV contrast for cholangiogram?

The common intravenous contrast solution is meglumine ioglycamate. This is an iodine-based dye. Patients with an iodine allergy should not undergo this test.

The test is used to look for gallstones or other abnormalities of the biliary tree. It is not a first line test and other imagining techniques are usually done initially to make a diagnosis. Ultrasound is used most frequently.

The risk of the test is related to the iodine-based dye that is injected intravenously. Especially patients with a history of kidney disease or suspected abnormal kidney function further testing is indicated before using iodine-based dye.