• Andrzej Cieszanowski, Anna Stadnik, Aleksandra Lezak, Edyta Maj, Krzysztof Zieniewicz, Katarzyna Rowinska-Berman, Ireneusz P Grudzinski, Marek Krawczyk, and Olgierd Rowiński.
• 2nd Department of Clinical Radiology, Medical University of Warsaw, ul. Banacha 1A, 02-097 Warszawa, Poland. Electronic address: andrzej.cieszanowski@wum.edu.pl.
• Eur J Radiol. 2013 Dec 1; 82 (12): 2176-82.

ObjectivesThe 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.MethodsThis 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.ResultsGd-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%.ConclusionsGd-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.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

27 keywords...

hide…