Fig. 16

A 6-year-old girl, also presenting with jaundice from a biliary rhabdomyosarcoma. a, b Transverse ultrasound images at diagnosis reveal marked intrahepatic biliary ductal dilatation (red arrows) measuring > 1 cm in diameter within both the right and left hepatic lobes. c, d Upon careful assessment of the common bile duct to its origin, a homogenous intra-ductal mass is identified (white arrows). e, f Axial T2-weighted MRI images through the liver, subsequently confirm the intrahepatic ductal dilatation (red arrows), with intra-ductal mass (white arrows) in keeping with the biliary rhabdomyosarcoma. g The 3D-MIP from the MRCP again helps to demonstrate the extent of the intrahepatic biliary ductal dilatation. In this clinical scenario, compared to the images of Fig. 15, the intra-ductal mass is harder to visualise on ultrasound without careful assessment of the common bile duct to its origin, highlighting the importance of careful assessment and patience to ensure all pertinent findings are identified