MR cholangiography in neonates and infants: feasibility and preliminary applications.

Guibaud, Laurent; Lachaud, A.; Touraine, R; Guibal, Aymeric; Pelizzari, Mario; Basset, Thierry; Pracros, J.P.

doi:10.2214/ajr.170.1.9423592

Cited by 75 publications

(26 citation statements)

References 13 publications

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“…It was reported that radionuclide-imaging of liver and gallbladder can give false positive results, since there is a fully obstructive stage due to cholangitis or cholestasis in neonatal hepatitis syndrome and infantile hepatitis syndrome [6][7][8] . When there is deficient choleresis or the diameter of biliary tract is too small, they would be easily misdiagnosed as BA [9][10][11] . With the improvement and updating of ultrasonic apparatus, and the enhancement of resolution, clear image can be obtained with a high frequency detecting head.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

Zhang²,

Sun³

et al. 2008

WJG

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AIM:To investigate the clinical value of ultrasonographic diagnosis of biliary atresia (BA), a retrospective analysis of the sonogram of 20 children with BA was undertaken. METHODS: Ultrasonography (US) was performed in 20 neonates and infants with BA, which was confirmed with cholangiography by operation or abdominoscopy. The presence of triangular cord, the size and echo of liver, the changes in empty stomach gallbladder and postprandial gallbladder were observed and recorded. RESULTS: The triangular cord could be observed at the porta hepatis (thickness: 0.3-0.6 cm) in 10 cases. Smaller triangular cord (0.2-0.26 cm) can be observed in 3 cases. The gallbladder was not observed in 2 cases, and 1 case showed a streak gallbladder without capsular space. The gallbladders of 15 cases were flat and small. The gallbladders of 2 cases were of normal size and appearance, however, there was no postprandial contraction. The livers of all cases showed hepatomegaly and heterogeneous echogenicity. Statistical analysis was performed to compare the hepatomegaly and heterogeneous echogenicity and the stage of hepatic fibrosis. CONCLUSION:The presence of the triangular cord at the porta hepatis is specific. However, it is not the only diagnostic criterion, since flat and small gallbladder and poor contraction are also of important diagnostic and differential diagnostic significance. The degree of hepatomegaly and heterogeneous echogenicity is proportional with liver fibrosis, and able to indicate the duration of course and prognosis.

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Section: Discussionmentioning

confidence: 99%

Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

Zhang²,

Sun³

et al. 2008

WJG

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“…[2] A number of diagnostic and therapeutic methods for inspissated bile syndrome have been studied. Magnetic resonance cholangiopancreatography (MRCP) [3,4] and endoscopic retrograde cholangiopancreatography (ERCP) [5,6] have been used in the diagnosis of obstructive jaundice, but they are clinically diffi cult to carry out for the treatment of inspissated bile syndrome.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystostomy and bile duct lavage for treatment of inspissated bile syndrome: a single-center experience

et al. 2011

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“…However, no single noninvasive examination that can be used to satisfactorily exclude biliary atresia as the cause of neonatal cholestasis is currently available, even though early diagnosis is critical for the prognosis and even more important for determining the treatment for biliary atresia. Hence, a number of imaging examinations, including US (18 -20), radionuclide cholescintigraphy (21,22), and MR cholangiography (23), have been used together to establish a more accurate diagnosis of biliary atresia less invasively and thereby reduce the need for open liver biopsy and exploratory cholangiography.…”

Section: Discussionmentioning

confidence: 99%

“…Biliary atresia can be ruled out if the complete extrahepatic biliary duct is identified at MR cholangiography (23). However, with MR cholangiography, one relies on the production and excretion of bile for visualization of the biliary system (27).…”

Section: Discussionmentioning

confidence: 99%

Biliary Atresia: Feasibility of Mangafodipir Trisodium–enhanced MR Cholangiography for Evaluation

Ryeom

Choe

Kim³

et al. 2005

Radiology

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The study was approved by the institutional review board, and informed consent was obtained from the patients' parents. Twenty-three consecutive infants suspected of having biliary atresia (BA) were prospectively examined by using mangafodipir trisodium (Mn-DPDP)-enhanced magnetic resonance (MR) cholangiography. Sequential T1-weighted spoiled gradient-echo MR cholangiograms were obtained 1, 2, and 3 hours after intravenous administration of Mn-DPDP. The possibility of BA was excluded if bowel excretion of contrast material was noted at contrast material-enhanced MR cholangiography. The diagnostic specificity and accuracy of contrast-enhanced MR cholangiography were compared with those of conventional MR cholangiography, technetium 99m Tc ((99m)Tc)-disofenin (DISIDA) scintigraphy, and the triangular cord sign at ultrasonography (US). MR cholangiography was used to accurately distinguish four cases of BA from 19 cases of other cholestatic liver diseases, without false-positive results. Conventional MR cholangiography, (99m)Tc-DISIDA scintigraphy, and the triangular cord sign at US respectively yielded false-positive results of 42% (eight of 19 infants), 35% (six of 17 infants), and 11% (two of 19 infants) in patients without BA. Mn-DPDP-enhanced MR cholangiography appears to be a promising modality for early diagnosis of BA as the cause of neonatal cholestasis.

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MR cholangiography in neonates and infants: feasibility and preliminary applications.

Cited by 75 publications

References 13 publications

Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

Laparoscopic cholecystostomy and bile duct lavage for treatment of inspissated bile syndrome: a single-center experience

Biliary Atresia: Feasibility of Mangafodipir Trisodium–enhanced MR Cholangiography for Evaluation

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