Biliary imaging: Caroli disease: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Biliary imaging: Caroli disease

Sample item

A young adult has recurrent cholangitis and portal hypertension. MRCP shows multiple saccular dilatations of the intrahepatic bile ducts, and contrast CT shows small dots of enhancement inside the dilated ducts. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Caroli disease

Caroli disease is a congenital segmental saccular dilatation of intrahepatic ducts, and portal radicles bridging the ducts produce the central dot sign. It predisposes to stones, cholangitis and cholangiocarcinoma.

Option by option

  • A. Primary sclerosing cholangitis

    Primary sclerosing cholangitis shows a beaded duct pattern with strictures.

  • B. Polycystic liver disease

    Polycystic liver disease cysts do not communicate with the bile ducts.

  • C. Cholangiocarcinoma

    Cholangiocarcinoma causes strictures and a mass, not multiple saccules with central dots.

  • D. Caroli disease (correct)

    Correct. Saccular ducts with the central dot sign are typical of Caroli disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Caroli disease. Caroli disease is a congenital segmental saccular dilatation of intrahepatic ducts, and portal radicles bridging the ducts produce the central dot sign.

Why is "Primary sclerosing cholangitis" not the answer?

Primary sclerosing cholangitis shows a beaded duct pattern with strictures.

Why is "Polycystic liver disease" not the answer?

Polycystic liver disease cysts do not communicate with the bile ducts.

Why is "Cholangiocarcinoma" not the answer?

Cholangiocarcinoma causes strictures and a mass, not multiple saccules with central dots.

What concept does this question test?

It tests Biliary imaging: Caroli disease in Radiology. It predisposes to stones, cholangitis and cholangiocarcinoma.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Biliary imaging: Caroli disease?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.