Detection of active bile leak with Gd-EOB-DTPA enhanced MR cholangiography: Comparison of 20-25 min delayed and 60-180 min delayed images

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• 作者：Andrzej Cieszanowski ; Anna Stadnik ; Aleks ; ra Lezak ; Edyta Maj ; Krzysztof Zieniewicz ; Katarzyna Rowinska-Berman ; Ireneusz P. Grudzinski ; Marek Krawczyk ; Olgierd Rowi艅ski
• 关键词：Bile leak ; Bile duct injury ; MR imaging ; MR contrast agents ; MRCP
• 刊名：European Journal of Radiology
• 出版年：December, 2013
• 年：2013
• 卷：82
• 期：12
• 页码：2176-2182
• 全文大小：2880 K

文摘

Objectives

The purpose of this study was to assess the value of contrast-enhanced magnetic resonance cholangiography (MRC) performed in different time delays after injection of gadoxetic acid disodium (Gd-EOB-DTPA) for the diagnosis of active bile leak.

Methods

This retrospective analysis included Gd-EOB-DTPA enhanced MR images of 34 patients suspected of bile leak. Images were acquired 20-25 min after Gd-EOB-DTPA injection. If there was inadequate contrast in the bile ducts then delayed images after 60-90 min and 150-180 min were obtained. Results were correlated with intraoperative findings, ERCP results, clinical data, laboratory tests, and follow-up examinations.

Results

Gd-EOB-DTPA enhanced MRC yielded an overall sensitivity of 96.4%, specificity of 100% and accuracy of 97.1% for the diagnosis of an active bile leak. The sensitivity of 20-25 min delayed MR images was 42.9%, of combined 20-25 min and 60-90 min delayed images was 92.9% and of combined 20-25 min, 60-90 min and 150-180 min delayed images was 96.4%.

Conclusions

Gd-EOB-DTPA enhanced MRC utilizing delayed phase images was effective for detecting the presence and location of active bile leaks. The images acquired 60-180 min post-injection enabled identification of bile leaks even in patients with a dilated biliary system or moderate liver dysfunction.