Biliary motor function in gallstone patients evaluated by fatty‐meal MR cholangiography

Abstract

Purpose:To investigate the possibility of evaluating biliary motor function with magnetic resonance cholangiography (MRC). Materials and Methods:Twenty patients with gallstones and 30 control subjects were studied using fatty-meal MRC. After baseline MRC, they were encouraged to drink 250 mL of milk and underwent postprandial MRC every 10 minutes for 60 minutes. Postprandial changes in gallbladder volume and the diameter of the common duct were assessed as indicators of gallbladder contractility and biliary obstruction, respectively. Postprandial dilatation at 60 minutes was considered indicative of persistent biliary obstruction.Results: Gallbladder ejection fraction was calculated at 66.0% Ϯ 12.2% (range, 40.3%-88.6%) in the controls. Gallbladder volume expressed as a percentage of the baseline value was significantly larger at 20 -60 minutes in the gallstone patients than in the controls. Gallbladder ejection fraction varied widely (mean, 46.4% Ϯ 24.4%; range, 2.8%-81.5%) and was significantly reduced in comparison with that of the controls (P Ͻ 0.01). In two gallstone patients with co-existing ductal stones, transient postprandial dilatation associated with ampullary impaction was observed. Persistent biliary obstruction was not indicated in any subjects. Conclusion:The results of this study suggest the feasibility of fatty-meal MRC, as well as its potential for evaluating biliary motor function.

MR Imaging of the Gallbladder: A Pictorial Essay

“…The gallbladder ejection fraction following the infusion of cholecystokinin has been found to correlate with that measured at hepatobiliary scintigraphy performed with HIDA. It is possible to assess the patency and range of contractions of that portion of the bile duct covered by the sphincter of Oddi with pharmacodynamic MR cholangiopancreatography after the ingestion of a fatty meal or the infusion of secretin (52).…”

Gallbladder Dysfunction: How Much Longer Will It Be Controversial?

“…Other stimulants for gallbladder contractility have been studied as well, especially during shortages of pharmacologic CCK, such as a lactose-free fatty meal [42,43,44,45,46], including the use of a fatty meal during magnetic resonance imaging (MRI) cholangiography to assess GBEF [47]. Indeed, Marciani et al [48] evaluated a number of food products on gallbladder contractility by studying the changes in gallbladder size with use of MRI, and found that long-chain fatty acids was the most potent stimulator of gallbladder contractility and also induced the highest serum concentration of CCK.…”

Oral Cholecystagogue Cholescintigraphy

“…Meal composition varied widely, including dried egg yolk, 13 milk, [14][15][16][17] half milk and half cream, 18,19 Lipomul (corn oil emulsion marketed by Upjohn and discontinued in 1979), 20 corned beef and cheese sandwich, 12 bacon roll, 21 a candy bar, 22 and dietary supplements. 23 In 1 study, sham feeding was used, involving chewing of food, without ingestion.…”