Radiologic Evaluation of Structure and Function of the Sphincter of Oddi

Wiedmeyer, D A; Stewart, Edward T.; Taylor, Andrew

doi:10.1016/s1052-5157(18)30591-9

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…The common bile duct consists of supraduodenal, retroduodenal, pancreatic, and intraduodenal segments (12)(13)(14). The sphincter of Oddi is a muscle that typically encircles the terminal portions of the biliary and pancreatic ducts and their common channel (15)(16)(17) (Fig 2). There remains some debate as to whether the sphincter of Oddi is a single continuous structure or consists of two or three separate structures.…”

Section: Anatomy Of the Biliary Systemmentioning

confidence: 99%

“…There is less variability in the common bile duct, except in size (12). In 5%-15% of the population, the common bile duct and main pancreatic duct enter the duodenum separately (17,18). Fig 7), found in 11%; distal confluence of the posterior and anterior segmental right hepatic ducts (D ; Fig 8), found in 12%; direct confluence of the posterior segmental right hepatic duct with the common hepatic duct (E ; Fig 5), found in 5%; distal confluence of the posterior and anterior segmental right hepatic ducts, with a separate accessory right duct draining into the left hepatic duct (F ; Fig 9), rarely found; and quadriform anomaly (G; Fig 10), also rarely found.…”

Section: Anatomy Of the Biliary Systemmentioning

confidence: 99%

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MR Cholangiopancreatography: Improved Ductal Distention with Intravenous Morphine Administration

Silva¹,

Friese²,

Hara³

et al. 2004

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Magnetic resonance (MR) cholangiopancreatography has proved a robust and noninvasive imaging modality for evaluating the biliary and pancreatic ducts without the use of ionizing radiation. Although MR cholangiopancreatography reliably depicts the main extrahepatic and intrahepatic bile ducts, it does not depict the segmental intrahepatic ducts unless they are dilated. The segmental ducts are difficult to visualize with MR cholangiopancreatography because of their small caliber and the limited spatial resolution and signal-to-noise ratio achievable with standard MR pulse sequences. However, visualization of the normal (ie, nondistended) biliary system is necessary for the evaluation of donor candidates for living related liver transplantation. Because of the prevalence of variant biliary anatomy, MR cholangiopancreatography is often used for preoperative evaluation of prospective liver donors. Intravenous morphine administered prior to MR cholangiopancreatography can improve image quality by causing the sphincter of Oddi to contract, which increases pressure in and distention of the biliary and pancreatic ducts. Morphine administration may also be particularly helpful for the evaluation of patients with primary sclerosing cholangitis, malignant neoplasms such as cholangiocarcinoma, or cystic and non-organ-deforming benign pancreatic neoplasms.

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Section: Anatomy Of the Biliary Systemmentioning

confidence: 99%

Section: Anatomy Of the Biliary Systemmentioning

confidence: 99%

MR Cholangiopancreatography: Improved Ductal Distention with Intravenous Morphine Administration

Silva¹,

Friese²,

Hara³

et al. 2004

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“…Fatty‐meal MRC may be a unique tool for investigating the pathophysiology of biliary disorders. Choledocholithiasis may induce papillitis and, subsequently, sphincter of Oddi stenosis; on the other hand, sphincter of Oddi dysfunction may cause biliary stasis in the common bile duct, presumably leading to stone formation (27). Biliary obstruction in choledocholithiasis is inferred to be ascribable to either sphincter of Oddi dysfunction or stone impaction.…”

Section: Discussionmentioning

confidence: 99%

Biliary motor function in gallstone patients evaluated by fatty‐meal MR cholangiography

Inoue

Komatsu

Yoshikawa

et al. 2003

Magnetic Resonance Imaging

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Purpose:To investigate the possibility of evaluating biliary motor function with magnetic resonance cholangiography (MRC). Materials and Methods:Twenty patients with gallstones and 30 control subjects were studied using fatty-meal MRC. After baseline MRC, they were encouraged to drink 250 mL of milk and underwent postprandial MRC every 10 minutes for 60 minutes. Postprandial changes in gallbladder volume and the diameter of the common duct were assessed as indicators of gallbladder contractility and biliary obstruction, respectively. Postprandial dilatation at 60 minutes was considered indicative of persistent biliary obstruction.Results: Gallbladder ejection fraction was calculated at 66.0% Ϯ 12.2% (range, 40.3%-88.6%) in the controls. Gallbladder volume expressed as a percentage of the baseline value was significantly larger at 20 -60 minutes in the gallstone patients than in the controls. Gallbladder ejection fraction varied widely (mean, 46.4% Ϯ 24.4%; range, 2.8%-81.5%) and was significantly reduced in comparison with that of the controls (P Ͻ 0.01). In two gallstone patients with co-existing ductal stones, transient postprandial dilatation associated with ampullary impaction was observed. Persistent biliary obstruction was not indicated in any subjects. Conclusion:The results of this study suggest the feasibility of fatty-meal MRC, as well as its potential for evaluating biliary motor function.

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“…Terminal portion of CBD is joined by pancreatic duct. The sphincter of Oddi is a muscle that typically encircles the terminal portion of biliary and pancreatic ducts and their common channel (figure 2b) [45][46][47] . There remains some debate as to whether the sphincter of Oddi is a single continuous structure or consists of two or three separate structures.…”

Section: Anatomy Of Biliary Systemmentioning

confidence: 99%

MR Cholangio-Pancreaticography as a Tool for Evaluation of Patients With Pancreaticobiliary Diseases

Nadaf¹,

ijar²,

C.P³

et al. 2020

IJAR

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Objectives Of Study: 1. To describe features of pancreaticobiliary diseases on MRCP. 2. Outlining the extent in terms of involvement of adjacent structures, vesselsâ€¨and soft tissues. â€¨ 3. To help in deciding further course of management. 4. To identify the anatomical variants. â€¨ 5. To prove the Magnetic Resonance Cholangio-Pancreatography (MRCP) isâ€¨one of the best imaging modality for evaluation of pancreatico-biliary disease. Material And Methods:The present study was undertaken to evaluate the role of MRCP in evaluation of pancreaticobiliary diseases. The study will be done on patients presenting with features suggestive of pancreatico-biliary diseases attending the OPD or admitted in various wards of Krishna Rajendra hospital, Mysore attached to Mysore Medical College & Research Institute, Mysore. A total of 30 patients were included in our study. Result:Majority of patients in study population were males (60%) while 40% were females. The mean age of the study sample was 37.5 years and maximum numbers of cases were observed in age group of > 40 years. Majority of pathologies observed were benign 18(60%). Pancreatitis was the most common finding (33.3%) followed by Cholangiocarcinoma (20%), Choledocholithiasis (13.4%), Periampullary carcinoma (10%), Ca. Pancreas (6.7%) & Choledochal cyst (6.7%).Pancreatitis is common in males followed by Cholangiocarcinoma, which is common in both males & females.Both benign & malignant strictures have equal predominance. Both benign & malignant strictures are common in proximal CBD. Conclusion: MRCP is non-invasive, non-ionizing imaging method for evaluation of pancreatico-biliary anatomy and pathology. It is superior diagnostic modality in detection and characterization of pancreatico-biliary pathologies.

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Radiologic Evaluation of Structure and Function of the Sphincter of Oddi

Cited by 9 publications

References 39 publications

MR Cholangiopancreatography: Improved Ductal Distention with Intravenous Morphine Administration

MR Cholangiopancreatography: Improved Ductal Distention with Intravenous Morphine Administration

Biliary motor function in gallstone patients evaluated by fatty‐meal MR cholangiography

MR Cholangio-Pancreaticography as a Tool for Evaluation of Patients With Pancreaticobiliary Diseases

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