A large number of gadolinium chelates have recently been tested in clinical
trials. Some of those have already been approved for clinical use in the United
States and Europe. Thus, new diagnostic perspectives have been incorporated into
magnetic resonance imaging studies. Among such gadolinium chelates are
hepatobiliary-specific contrast agents (HSCAs), which, due to their property of
being selectively taken up by hepatocytes and excreted by the biliary ducts,
have been widely used for the detection and characterization of focal hepatic
lesions. In comparison with conventional magnetic resonance cholangiography
(MRC), HSCA-enhanced MRC provides additional information, with higher spatial
resolution and better anatomic evaluation of a non-dilated biliary tree. A
thorough anatomic assessment of the biliary tree is crucial in various hepatic
surgical procedures, such as complex resection in patients with colorectal
cancer and living-donor liver transplantation. However, the use of HSCA-enhanced
MRC is still limited, because of a lack of data in the literature and the poor
familiarity of radiologists regarding its main indications. This pictorial essay
aims to demonstrate the use of HSCA-enhanced MRC, with particular emphasis on
anatomical analysis of the biliary tree, clinical applications, and the most
important imaging findings.
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