Contrast-enhanced MR cholangiography (MRCP) with GD-EOB-DTPA in evaluating biliary complications after surgery

Sarchi, Luca; Urbinati, Costanza; Valeri, Gianluca; Ferrara, Calogero; Giovagnoni, Andrea

doi:10.1007/s11547-011-0731-4

Cited by 22 publications

(19 citation statements)

References 40 publications

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“…In patients with complete obstruction of the bile duct after trauma CE-MRC imaging shows proximal duct dilatation and lack of excretion of the contrast agent from the bile duct. Salvolini et al [18] determined the traumatic biliary injuries on CE-MRC images, with 64 % sensitivity. In this study we detected 12 (80 % sensitivity) of the 15 patients with biliary injury.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography

et al. 2013

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ObjectiveTo evaluate the added role of T1-weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) compared with T2-weighted MRC (T2w-MRC) in the detection of biliary leaks.MethodsNinety-nine patients with suspected biliary complications underwent routine T2w-MRC and T1w contrast-enhanced (CE) MRC using Gd-EOB-DTPA to identify biliary leaks. Two observers reviewed the image sets separately and together. MRC findings were compared with those of surgery and percutaneous transhepatic cholangiopancreatography. The sensitivity, specificity and accuracy of the techniques in identifying biliary leaks were calculated.ResultsAccuracy of locating biliary leaks was superior with the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC (P < 0.05).The mean sensitivities were 79 % vs 59 %, and the mean accuracy rates were 84 % vs 58 % for combined CE-MRC and T2w-MRC vs sole T2w-MRC. Nineteen out of 21 patients with biliary-cyst communication, 90.4 %, and 12/15 patients with post-traumatic biliary extravasations, 80 %, were detected by the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC images, P < 0.05.ConclusionsGd-EOB-DTPA-enhanced MRC yields information that complements T2w-MRC findings and improves the identification and localisation of the bile extravasations (84 % accuracy, 100 % specificity, P < 0.05). We recommend Gd-EOB-DTPA-enhanced MRC in addition to T2w-MRC to increase the preoperative accuracy of identifying and locating extravasations of bile.Key Points• Magnetic resonance cholangiography (MRC) does not always detect bile leakage and cysto-biliary communications.• Gd-EOB-DTPA-enhanced MRC helps by demonstrating extravasation of contrast material into fluid collections.• Gd-EOB-DTPA-enhanced MRC also demonstrates the leakage site and bile duct injury type.• Combined Gd-EOB-DTPA-enhanced and T2w-MRC can provide comprehensive information about biliary system.• Gd-EOB-DTPA-enhanced MRC is non-invasive and does not use ionising radiation.

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Section: Discussionmentioning

confidence: 99%

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography

et al. 2013

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“…Finally, biliary excretion of these contrast agents can visualize the bile duct system. There is emerging evidence that this technique is superior to conventional magnetic resonance cholangiopancreatography in certain clinical scenarios, such as in the evaluation of biliary complications after surgery (Salvolini et al, 2012). Clearly more clinical studies are needed before liver MRI with hepatobiliary contrast agents (EOB-DTPA or BOPTA) can be recommended as routine procedures.…”

Section: Role Of Imaging In Diagnosing Liver Diseasesmentioning

confidence: 99%

The Role of Organic Anion Transporters in Diagnosing Liver Diseases by Magnetic Resonance Imaging

2014

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The expression and transport functions of organic anion transporters are modified in liver diseases, and therefore the vascular clearances of endogenous and exogenous organic anions that are taken up by these transporters have been used to assess liver diseases in patients. More recently, liver imaging with hepatobiliary contrast agents, tracers, and dyes that cross hepatocytes through the organic anion transporting polypeptides (OATPs)-multidrug resistance-associated proteins (MRPs) pathway were developed to detect and characterize focal lesions and to assess the severity of diffuse liver diseases. This review focuses mainly on magnetic resonance imaging and highlights the growing interest in imaging the OATPs-MRP2 pathway to better understand liver diseases. Imaging provides noninvasive measurements of tissue concentrations that result from the interplay between influx and efflux membrane transport systems in normal or injured hepatocytes. Imaging with magnetic resonance hepatobiliary contrast agents improves the detection and the characterization of hepatic focal lesions. New developments of imaging to assess liver function and understand the hepatocellular concentrations of contrast agents are discussed.

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“…Over the last years, there has been an increasing interest in the use of CE-MRC in the post-surgical assessment of the biliary tree [28] . This technique is based on i.v.…”

Section: Contrast-enhanced Mrcmentioning

confidence: 99%

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

Girometti

Cereser

Bazzocchi

et al. 2014

WJR

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Core tip:The review is focused on three main topics, in order to emphasize why magnetic resonance cholangiography (MRC) is the preferred imaging modality to noninvasively assess the biliary system after orthotopic liver transplantation. First, the authors describe the different techniques that can be used, namely conventional MRC and contrast-enhanced MRC. Second, exemplificative imaging findings are illustrated in order to show the diagnostic reliability of the technique. Third, the Authors discuss the state-of-the-art role for MRC in assessing biliary complications as emerging from updated literature review. INTRODUCTIONDespite improvements in organ preservation, surgical technique, immunosuppression and postoperative management, biliary complications (BC) still represent the "Achille's heel" of orthotopic liver transplantation (OLT),

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Contrast-enhanced MR cholangiography (MRCP) with GD-EOB-DTPA in evaluating biliary complications after surgery

Abstract: Hepatobiliary-specific contrast agents allow for accurate and extensive study of biliary tract alterations, especially in assessing postsurgical complications.

Cited by 22 publications

References 40 publications

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography

The Role of Organic Anion Transporters in Diagnosing Liver Diseases by Magnetic Resonance Imaging

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

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