Functional MR cholangiography of the cystic duct and sphincter of Oddi using gadoxetate disodium: Is a 30‐minute delay long enough?

Corwin, Michael T.; Lamba, Ramit; McGahan, John P.

doi:10.1002/jmri.23816

Cited by 14 publications

(4 citation statements)

References 26 publications

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“…Hepatobiliary scintigraphy has been used in the evaluation of SOD but it exposes the patient to ionizing radiation, lacks anatomic information regarding biliary tree, reports regarding accuracy are inconsistent and correlation with manometry results has been poor [16]. Secretin-stimulated MRCP has the potential to be the ideal imaging modality in evaluating SOD, as it can provide both functional and anatomic information, however the procedure is expensive, not covered by insurance and requires secretin injection, that is currently not registered for medical application by the Ministry of Health of Russian Federation [17]. In our study we chose fatty meal sonography as affordable quite reliable method for assessment of biliary tree emptying, that is an important criterion for diagnosing SOD [9].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Hymecromone in Post-Cholecystectomy Patients

Okhlobystin

Ufimtseva

Татаркина

et al. 2021

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Background. The cholecystectomy is the major cause of sphincter of Oddi dysfunction (SOD), that may be classified as post-cholecystectomy syndrome (PCES). Treatment of PCES requires in most of the cases application of selective antispasmodic drugs.Aim. To evaluate efficacy and safety of hymecromone in patients with post-cholecystectomy SOD, to compare standard and reduced doses of hymecromone.Methods. Overall, 26 patients were enrolled in non-interventional comparative study: 2 males, 24 females, aged from 25 to 74 years. All patients underwent cholecystectomy for symptomatic gallstone disease within 1 to 10 years prior to beginning of the study. All patients were diagnosed to have SOD according to Rome IV Diagnostic Criteria for functional biliary sphincter of Oddi disorder (E1b). All patients underwent hymecromone monotherapy for 3 weeks. Patients were randomized to group A and B to receive full-dose or half-dose of the drug respectively.Results. Abdominal pain completely subsided in 85 % of patients, significant improvement was found for bloating and diarrhea. Mild increase in fasting common bile duct (CBD) diameter after treatment (7.23 ± 0.99 vs 6.78 ± 1.01; p = 0.029) was attributed to choleretic action of hymecromone. Hymecromone resulted in significant improvement of CBD response to fatty meal stimulation (ΔCBD): –1.08 ± 0.46 mm vs –0.10 ± 0.33 mm pretreatment (p = 0.016). Degree of improvement was more pronounced in the group A (full-dose) as compared to group B (half-dose) for abdominal pain (Z = 2.74, p = 0.031), bloating (Z = 2.63, p = 0.035) and constipation (Z = 2.61, p = 0.038)Conclusion. Hymecromone demonstrated itself to be an effective and safe drug, that may be applied both in standard and half dose. However, the efficacy of full-dose is higher both for the treatment of biliary pain and dyspeptic symptoms. Transabdominal ultrasound may be applied as a reliable test for both prediction of treatment efficacy and to monitor patients state during treatment course.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Hymecromone in Post-Cholecystectomy Patients

Okhlobystin

Ufimtseva

Татаркина

et al. 2021

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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“…Functional MRI is a class of imaging methods that is quite popular due to its wide availability, non-invasive nature, relatively low cost and good resolution. The visualization of the biliary tract is possible using gadolinium-based contrast agents that are taken up by normal hepatocytes and partially excreted in the biliary system [46]. Functional MRI is similar to hepatobiliary scintigraphy, but with a higher resolution, and the hypothesis that SOD is caused by the delayed emptying of a biliary excreted contrast agent to the duodenum is investigated [37].…”

Section: Diagnostic Challengesmentioning

confidence: 99%

Dysfunction of Biliary Sphincter of Oddi—Clinical, Diagnostic and Treatment Challenges

Kegnæs,

Novovic,

Shabanzadeh

2023

JCM

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Biliary Sphincter of Oddi dysfunction (SOD) is one of the main causes of post-cholecystectomy pain. In this review, we aimed to provide an update on the current knowledge on biliary SOD, with an emphasis on diagnostics and therapy. Overall, current but scarce data support biliary sphincterotomy for patients with type 1 and 2 SOD, but not for type 3. However, sphincterotomy is associated with post-treatment pancreatitis rates of from 10% to 15%, thus calling for improved diagnostics, patient selection and treatment modalities for SOD. The role of pharmacologic therapy for patients with SOD is poorly explored and only two randomized controlled trials are available. Currently, studies comparing treatment outcomes are few. There is an unmet need for randomized sham/placebo-controlled clinical trials related to both pharmacological and non-pharmacological treatments of SOD.

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“…However, it contains no dynamic functional information such as biliary excretion. On the other hand, MR cholangiography (MRC) with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) which is excreted into the bile ducts by a cellular process at the level of the hepatocyte can be used to obtain noninvasively high resolution postcontrast T1-weighted MR imaging, or so called functional MRC [ 3 – 11 ]. Until now, the functional MRC using Gd-EOB-DTPA has been used to evaluate cystic duct patency [ 3 , 12 , 13 ], biliary anatomy [ 3 , 14 , 15 ], relationship between the degree of biliary excretion and liver function [ 6 , 16 , 17 ], bile duct obstruction [ 18 ], bile duct injury including leakage and fistula [ 19 – 22 ], and biliary reflux [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Accumulation of Bile in the Gallbladder: Evaluation by means of Serial Dynamic Contrast-Enhanced Magnetic Resonance Cholangiography with Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid

Tamada

Ito

Yasokawa

et al. 2014

Gastroenterology Research and Practice

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The aim of this study was to evaluate the process of biliary excretion of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) into the biliary tract and to assess the accumulation patterns in the gallbladder using MR cholangiography obtained with Gd-EOB-DTPA which is a liver-specific hepatobiliary contrast agent. Seventy-five patients underwent Gd-EOB-DTPA enhanced MR imaging. Serial multiphasic hepatobiliary phase imaging was qualitatively reviewed to evaluate the process of the biliary excretion of contrast agent into the bile duct and the gallbladder. The accumulation pattern of contrast agent into gallbladder was classified into two groups (group 1 = orthodromic type and group 2 = delayed type). Furthermore, the results in differences of the presence of T1 hyperintense bile or sludge of gallbladder, gall stones, wall thickening of gallbladder, chronic liver disease, and liver cirrhosis between two groups were compared. Forty-eight of 75 patients (64%) were included in group 1, and remaining 27 (36%) were in group 2. The frequency of the presence of T1 hyperintense bile or sludge of gallbladder was significantly higher in patients with group 2 than that in patients with group 1 (P = 0.041). MR cholangiography obtained with Gd-EOB-DTPA showed that there may be an association between the biliary accumulation pattern in the gallbladder and the pathological condition.

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Functional MR cholangiography of the cystic duct and sphincter of Oddi using gadoxetate disodium: Is a 30‐minute delay long enough?

Cited by 14 publications

References 26 publications

Efficacy of Hymecromone in Post-Cholecystectomy Patients

Efficacy of Hymecromone in Post-Cholecystectomy Patients

Dysfunction of Biliary Sphincter of Oddi—Clinical, Diagnostic and Treatment Challenges

Accumulation of Bile in the Gallbladder: Evaluation by means of Serial Dynamic Contrast-Enhanced Magnetic Resonance Cholangiography with Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid

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