Diagnostic Possibilities of Magnetic Resonance Cholangiography with Intravenous Contrast in Diseases of the Bile Ducts
- Authors: Karmazanovsky G.G.1, Chzhao A.V.1, Ayvazyan K.A.1, Goncharov A.B.1, Saraeva V.A.1, Trifonov S.A.1
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Affiliations:
- Vishnevsky National Medical Research Center of Surgery
- Issue: Vol 77, No 5 (2022)
- Pages: 320-325
- Section: GASTROENTEROLOGY: CURRENT ISSUES
- URL: https://vestnikramn.spr-journal.ru/jour/article/view/2064
- DOI: https://doi.org/10.15690/vramn2064
Cite item
Abstract
Every year the number of operations on the hepatobiliary zone is steadily increasing due to diseases of the bile ducts. Against this background, there is a need for an accurate diagnosis of complications of these interventions; classical magnetic resonance cholangiopancreatography (MRCP) is of limited use. With the introduction of a liver-specific contrast agent (Gd-EOB-DTPA), the possibility of diagnosing diseases of the bile ducts has expanded. In this clinical review, we review the technical aspects and benefits of Gd-EOB-DTPA-enhanced MR cholangiography. Various types of contrast agents, methods of their use in MRI, the dependence of the signal intensity in the bile ducts on the time of administration of the substance, the presence of chronic liver diseases are covered in detail. Separately, studies are given on the diagnosis of diseases of the bile ducts with altered biliary anatomy, biliary fistulas after surgical interventions. In conclusion, data are presented on promising studies of the functional state of the liver based on the use of MRI with hepatotropic contrast enhancement.
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About the authors
Grigoriy G. Karmazanovsky
Vishnevsky National Medical Research Center of Surgery
Email: karmazanovsky@ixv.ru
ORCID iD: 0000-0002-9357-0998
SPIN-code: 5964-2369
MD, PhD, Professor, Corresponding Member of the RAS
Russian Federation, MosсowAlexey V. Chzhao
Vishnevsky National Medical Research Center of Surgery
Email: chzhao@ixv.ru
ORCID iD: 0000-0002-0204-8337
SPIN-code: 1101-6874
MD, PhD, Professor
Russian Federation, MosсowKhachatur A. Ayvazyan
Vishnevsky National Medical Research Center of Surgery
Email: ayvazyan@ixv.ru
ORCID iD: 0000-0002-4115-6963
SPIN-code: 3954-7051
Researcher Associate
Russian Federation, MosсowAnton B. Goncharov
Vishnevsky National Medical Research Center of Surgery
Email: goncharov@ixv.ru
ORCID iD: 0000-0002-3528-036X
SPIN-code: 1749-7490
Researcher Associate
Russian Federation, MosсowVeronika A. Saraeva
Vishnevsky National Medical Research Center of Surgery
Email: saraeva@ixv.ru
ORCID iD: 0000-0003-4273-171X
PhD Student
Russian Federation, MosсowSergey A. Trifonov
Vishnevsky National Medical Research Center of Surgery
Author for correspondence.
Email: trifonov@ixv.ru
ORCID iD: 0000-0003-1176-1203
SPIN-code: 7877-1999
MD
Russian Federation, MosсowReferences
- Barish MA, Soto JA, Yucel EK. Magnetic resonance cholangiopancreatography of the biliary ducts: techniques, clinical applications, and limitations. Top Magn Reson Imaging. 1996;8(5):302–311.
- Barish MA, Soto JA. MR cholangiopancreatography: techniques and clinical applications. AJR Am J Roentgenol. 1997;169(5):1295–1303. doi: https://doi.org/10.2214/ajr.169.5.9353445
- Reinbold C, Bret PM, Guibaud L, et al. MR cholangiopancreatography: potential clinical applications. Radiographics. 1996;16(2):309–320. doi: https://doi.org/10.1148/radiographics.16.2.8966289
- Reinhold C, Bret PM. MR cholangiopancreatography. Abdom Imaging. 1996;21(2):105–116. doi: https://doi.org/10.1007/s002619900025
- Reinhold C, Bret PM. Current status of MR cholangiopancreatography. AJR Am J Roentgenol. 1996;166(6):1285–1295. doi: https://doi.org/10.2214/ajr.166.6.8633434
- Zimmon DS, Falkenstein DB, Riccobono C, et al. Complications of endoscopic retrograde cholangiopancreatography. Analysis of 300 consecutive cases. Gastroenterology. 1975;69(2):303–309.
- Bilbao MK, Dotter CT, Lee TG, et al. Complications of endoscopic retrograde cholangiopancreatography (ERCP). A study of 10,000 cases. Gastroenterology. 1976;70(3):314–320.
- Van Hoe L, Gryspeerdt S, Vanbeckevoort D, et al. Normal Vaterian sphincter complex: evaluation of morphology and contractility with dynamic single-shot MR cholangiopancreatography. AJR Am J Roentgenol. 1998;170(6):1497–1500. doi: https://doi.org/10.2214/ajr.170.6.9609161
- Watanabe Y, Dohke M, Ishimori T, et al. Pseudo-obstruction of the extrahepatic bile duct due to artifact from arterial pulsatile compression: a diagnostic pitfall of MR cholangiopancreatography. Radiology. 2000;214(3):856–860. doi: https://doi.org/10.1148/radiology.214.3.r00mr09856
- Guibaud L, Bret PM, Reinhold C, et al. Bile duct obstruction and choledocholithiasis: diagnosis with MR cholangiography. Radiology. 1995;197(1):109–115. doi: https://doi.org/10.1148/radiology.197.1.7568807
- Кармазановский Г.Г., Шантаревич М.Ю., Сташкив В.И. Гепатоспецифическое МР-контрастное средство гадоксетовая кислота и результаты его клинического применения. — М.: Видар-М, 2022. — 168 с. [Karmazanovskij GG, Shantarevich MYu, Stashkiv VI. Gepatospecificheskoe MR-kontrastnoe sredstvo gadoksetovaya kislota i rezul’taty ego klinicheskogo primeneniya. Moscow: Vidar-M; 2022. 168 s. (In Russ.)]
- Sicklick JK, Camp MS, Lillemoe KD, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients. Ann Surg. 2005;241(5):786–792. doi: https://doi.org/10.1097/01.sla.0000161029.27410.71
- Laasch HU, Martin DF. Management of benign biliary strictures. Cardiovasc Intervent Radiol. 2002;25(6):457–466. doi: https://doi.org/10.1007/s00270-002-1888-y
- Zeman RK, Lee C, Stahl RS, et al. Ultrasonography and hepatobiliary scintigraphy in the assessment of biliary-enteric anastomoses. Radiology. 1982;145(1):109–115. doi: https://doi.org/10.1148/radiology.145.1.6812157
- Alabdulghani F, Healy GM, Cantwell CP. Radiological findings in ischaemic cholangiopathy. Clin Radiol. 2020;75(3):161–168. doi: https://doi.org/10.1016/j.crad.2019.10.017
- Cronan JJ. Biliary obstruction: ultrasound and beyond. Appl Radiol. 1987;16:55–63.
- Lucas MH, Elgazzar AH, Cummings DD. Positional biliary stasis: scintigraphic findings following biliary-enteric bypass surgery. J Nucl Med. 1995;36(1):104–106.
- Thomas S, Jahangir K. Noninvasive Imaging of the Biliary System Relevant to Percutaneous Interventions. Semin Intervent Radiol. 2016;33(4):277–282. doi: https://doi.org/10.1055/s-0036-1592328
- Hoeffel C, Azizi L, Lewin M, et al. Normal and pathologic features of the postoperative biliary tract at 3D MR cholangiopancreatography and MR imaging. Radiographics. 2006;26(6):1603–1620. doi: https://doi.org/10.1148/rg.266055730
- Tang Y, Yamashita Y, Arakawa A, et al. Pancreaticobiliary ductal system: value of half-Fourier rapid acquisition with relaxation enhancement MR cholangiopancreatography for postoperative evaluation. Radiology. 2000;215(1):81–88. doi: https://doi.org/10.1148/radiology.215.1.r00ap0281
- Soto JA, Alvarez O, Lopera JE, et al. Biliary obstruction: findings at MR cholangiography and cross-sectional MR imaging. Radiographics. 2000;20(2):353–366. doi: https://doi.org/10.1148/radiographics.20.2.g00mc06353
- Hottat N, Winant C, Metens T, et al. MR cholangiography with manganese dipyridoxyl diphosphate in the evaluation of biliary-enteric anastomoses: preliminary experience. AJR Am J Roentgenol. 2005;184(5):1556–1562. doi: https://doi.org/10.2214/ajr.184.5.01841556
- Bridges MD, May GR, Harnois DM. Diagnosing biliary complications of orthotopic liver transplantation with mangafodipir trisodium-enhanced MR cholangiography: comparison with conventional MR cholangiography. AJR Am J Roentgenol. 2004;182(6):1497–1504. doi: https://doi.org/10.2214/ajr.182.6.1821497
- Kandasamy D, Sharma R, Seith Bhalla A, et al. MR evaluation of biliary-enteric anastomotic stricture: does contrast-enhanced T1W MRC provide additional information? Clin Res Hepatol Gastroenterol. 2011;35(8–9):563–571. doi: https://doi.org/10.1016/j.clinre.2011.05.008
- Schneider G, Grazioli L, Saini S (eds). MRI of the liver: imaging techniques, contrast enhancement, differential diagnosis. 2nd ed. New York: Springer; 2006. 412 p.
- European Medicines Agency [Electronic resource]. Available from: https://www.ema.europa.eu/en/medicines/human/EPAR/teslascan (accessed: 02.08.2012).
- Takao H, Akai H, Tajima T, et al. MR imaging of the biliary tract with Gd-EOB-DTPA: effect of liver function on signal intensity. Eur J Radiol. 2011;77(2):325–329. doi: https://doi.org/10.1016/j.ejrad.2009.08.008
- Lee NK, Kim S, Lee JW, et al. Biliary MR imaging with Gd-EOB-DTPA and its clinical applications. Radiographics. 2009;29(6):1707–1724. doi: https://doi.org/10.1148/rg.296095501
- Tschirch FT, Struwe A, Petrowsky H, et al. Contrast-enhanced MR cholangiography with Gd-EOB-DTPA in patients with liver cirrhosis: visualization of the biliary ducts in comparison with patients with normal liver parenchyma. Eur Radiol. 2008;18(8):1577–1586. doi: https://doi.org/10.1007/s00330-008-0929-6
- Арутюнянц Д.Э., Ховрин В.В., Галян Т.Н., и др. Определение функции печени с помощью магнитно-резонансной томографии. Современная объективная реальность // Хирургия. Журнал им. Н.И. Пирогова. — 2021. — Т. 6. — № 2. — С. 89–94. [Arutyunyants DE, Khovrin VV, Galyan TN, et al. Magnetic resonance imaging in liver function analysis. Modern objective reality. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2021;6(2):89–94. (In Russ.)] doi: https://doi.org/10.17116/hirurgia202106289
- Мнацаканян М.К., Рубцова Н.А., Кабанов Д.О., и др. Роль магнитно-резонансной томографии с гадоксетовой кислотой в оценке функционального резерва печени // Российский электронный журнал лучевой диагностики. — 2022. — Т. 12. — № 1. — С. 43–55. [Mnatsakanyan MK, Rubtsova N., Kabanov DO, et al. The role of magnetic resonance imaging with gadoxetic acid in the assessment of the functional reserve of the liver. REJR. 2022;12(1):43–55. (In Russ.)] doi: https://doi.org/10.21569/2222-7415-2022-12-1-43-55
- Sheppard D, Allan L, Martin P, et al. Contrast-enhanced magnetic resonance cholangiography using mangafodipir compared with standard T2W MRC sequences: a pictorial essay. J Magn Reson Imaging. 2004;20(2):256–263. doi: https://doi.org/10.1002/jmri.20114
- Carlos RC, Branam JD, Dong Q, et al. Biliary imaging with Gd-EOB-DTPA: is a 20-minute delay sufficient? Acad Radiol. 2002;9(11):1322–1325. doi: https://doi.org/10.1016/s1076-6332(03)80565-2
- Ribeiro BJ, Alves AMA, de Oliveira RS, et al. The role of gadoxetic acid-enhanced magnetic resonance cholangiography in the evaluation of postoperative bile duct injury: pictorial essay. Radiol Bras. 2019;52(6):403–407. doi: https://doi.org/10.1590/0100-3984.2018.0089
- Vosshenrich J, Boll DT, Zech CJ. Passive and active magnetic resonance cholangiopancreatography: Technique, indications, and typical anatomy. Radiologe. 2019;59(4):306–314. doi: https://doi.org/10.1007/s00117-019-0507-8
- Aduna M, Larena JA, Martín D, et al. Bile duct leaks after laparoscopic cholecystectomy: value of contrast-enhanced MRCP. Abdom Imaging. 2005;30(4):480–487. doi: https://doi.org/10.1007/s00261-004-0276-2
- Petrillo M, Ierardi AM, Tofanelli L, et al. Gd-EOB-DTP-enhanced MRC in the preoperative percutaneous management of intra and extrahepatic biliary leakages: does it matter? Gland Surg. 2019;8(2):174–183. doi: https://doi.org/10.21037/gs.2019.03.09
- Strasberg SM, Helton WS. An analytical review of vasculobiliary injury in laparoscopic and open cholecystectomy. HPB (Oxford). 2011;13(1):1–14. doi: https://doi.org/10.1111/j.1477-2574.2010.00225.x
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