ABSTRACT
Imaging studies are now a key component in the investigation of paediatric hepatobiliary disease. Our understanding of the pathogenesis and natural history of these disorders has been paralleled by the development and introduction of these radiological techniques into clinical practice. Advances in ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and invasive vascular and biliary techniques have allowed a clear demonstration of vascular and biliary anatomy and an accuracy in the detection of small liver tumours that would not have been possible a decade or two ago. The challenge for clinicians and radiologists is to learn the appropriate use of this technology, which continues to evolve through the manipulation of physical rather than biological principles. An understanding of the limitations of individual techniques is as important to the radiologist as recognising their diagnostic potential. Experience has shown that no imaging technique stands alone, and although imaging-based protocols are of value, they have to be tailored to the individual child. Although didactic algorithms of investigation can be used as a guide, there will always be variance in observation, equipment and radiological experience that may adversely affect or advance the diagnostic pathway.
