Functional evaluation of cystic duct patency with Gd-EOB-DTPA MR imaging: an alternative to hepatobiliary scintigraphy for diagnosis of acute cholecystitis?

Abstract

MR cholangiography with hepatobiliary MR contrast agents such as Gd-EOB-DTPA can demonstrate cystic duct patency with high sensitivity. MR protocols can be designed within a clinically feasible timeframe to optimize diagnosis of acute cholecystitis.

The Impact of Gd-Eob-Dtpa-Enhanced MR Cholangiography in Biliary Diseases: Comparison with T2-Weighted MR Cholangiopancreatography

“…T2w-MRCP highlights the biliary tree, especially with heavily T2w sequences. However, in some circumstances, T2w-MRCP might be insufficient, especially in the diagnosis of acute cholecystitis biliary leakage and gallbladder perforation (5,14,15). We suggest that contrast enhanced MRC sequences can increase the diagnostic performance of Currently, there are two contrast agents which can be used to perform contrast enhanced MRC: Gd-EOB-DTPA and Gd-BOPTA.…”

“…However, the biliary extraction ratio of Gd-EOB-DTPA is about 50% and significantly higher than Gd-BOPTA (6). This allows a functional evaluation of the biliary system within 20 minutes after administration of the contrast agent in the patients with normal liver function (5,(17)(18)(19). In recent years, Dahlström et al (20) compared Gd-BOPTA and Gd-EOB-DTPA enhanced MRC images in terms of biliary tract enhancement in 10 healthy volunteers.…”

“…To the best of our knowledge, there are only limited published reports that have focused on the impact of contrast enhanced MRC in the evaluation of biliary diseases and variations (5)(6)(7)(8)(9). Those studies were achieved mostly with Gd-BOPTA (Gadobenate dimeglumine, Multihance®; Bracco, Princeton, NJ) and Mn-DPDP (Mangafodipir trisodium, Teslascan®; Nycomed Amersham, Princeton, NJ).…”

Evaluation of the gallbladder and cystic duct patency with gadoxetate disodium enhanced MR cholangiography: prospective comparison of patients with normal gallbladder function and acute cholecystitis

“…With the recent availability of hepatocyte-specific MRI contrast agents such as gadoxetate disodium, in addition to anatomic information, MRI can also provide functional information regarding the patency of the cystic duct similar to hepatobiliary scintigraphy (3,10,11). Obtaining both anatomic and functional information with one test may lead to better understanding of the pathophysiology of acute cholecystitis and also potentially may have an impact on management decisions.…”

“…More than 90% of cases occur in the setting of gallstone disease. Obstruction of cystic duct by a stone results in distention and inflammation of the gallbladder that may eventually lead to gallbladder ischemia and transmural necrosis (2)(3)(4)(5).…”