Initial experience on utility of gadobenate dimeglumine (Gd‐BOPTA) enhanced T1‐weighted MR cholangiography in diagnosis of acute cholecystitis

Abstract

PurposeTo investigate the feasibility of the use of gadobenate dimeglumine (also known as Gd‐BOPTA) ‐enhanced T1‐weighted MR cholangiography in diagnosis of acute cholecystitis.Materials and MethodsThis prospectively designed institutional review board‐approved HIPAA‐compliant study was done between January and November 2007. We included 11 consecutive patients (7 male, mean age 59 years) who presented to the emergency room with acute right upper quadrant pain and with equivocal physical examination and/or ultrasound findings. The control group included 15 patients who underwent liver MRI with Gd‐BOPTA. All patients underwent contrast‐enhanced (CE) MR cholangiography examinations. CE‐MR cholangiography was performed on a 1.5 Tesla magnet using 3D T1‐weighted high resolution isotrophic volume examination (THRIVE) obtained at the 90th min after intravenous injection of Gd‐BOPTA. Imaging features detected on CE‐MR cholangiography were correlated with operative and histopathologic findings.ResultsIn the control group, GD‐BOPTA was visualized within the gallbladder in all subjects. For the study group, gallstones were present in nine patients (n = 7 both in gallbladder and cystic duct, n = 1 only in gallbladder, n = 1 only in cystic duct) on MRCP. Hydropic gallbladder was detected in seven patients, significant wall thickening in seven patients, and pericholecystic free fluid in 6 patients. On delayed phase CE cholangiography, significant enhancement of gallbladder wall was seen in 10 patients, and contrast agent excretion into gallbladder was absent in all patients. Surgery was performed in 10 patients, and cholecystostomy was done in 1 patient. Surgery and histopathology findings were consistent with cholecystitis in all patients.ConclusionIn addition to anatomical assessment, Gd‐BOPTA‐enhanced MR cholangiography can provide functional evaluation similar to HIDA scintigraphy in diagnosing acute cholecystitis in patients with acute right upper quadrant pain and equivocal findings. J. Magn. Reson. Imaging 2009;30:578–585. © 2009 Wiley‐Liss, Inc.

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

“…Previous authors have demonstrated the potential efficacy of MR cholangiography utilizing Mangafodipir trisodium and Gd-BOPTA in the diagnosis of cholecystitis [18][19][20], however, these studies have extended imaging well beyond the standard 30 min imaging window. Morphologic features of cholecystitis on MR have also been established [21,22], but if MR is to play a significant role in the diagnosis of cholecystitis, it must be able to demonstrate cystic duct patency, and gallbladder reflux via functional evaluation akin to hepatobiliary scintigraphy.…”

Evaluating Patients with Right Upper Quadrant Pain

“…Recently, a potential role for T1-weighted MR cholangiography using agents that are both extracellular and hepatocyte specific with increased biliary excretion in the diagnosis of acute cholecystitis has been described. 121,122 This technique allows for functional evaluation as in hepatobiliary scintigraphy; however, further investigation in this application is needed.…”

Akut Abdomen

“…MRG akut kolesistitin saptanmasında, BT ve US'deki bulgulara benzer bulguları ile sensitif bir yöntemdir. Manyetik rezonans kolanjiyopankreatografi (MRKP) safra kesesi boynundaki veya sistik kanaldaki taşı gösterebilir [28].…”