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1.
Purpose
To evaluate the possible pancreatic changes and their frequencies in patients with primary sclerosing cholangitis (PSC) on MR cholangiopancreatography (MRCP), and conventional abdominal MRI.Materials and Methods
Patient group consisted of 29 PSC (13 male, 16 female) cases, whereas cohort 1 consisted of 12 female patients with primary biliary cirrhosis, and cohort 2 consisted of 17 patients (6 male, 11 female) with non-immune chronic liver disease. Two radiologists retrospectively evaluated the MR examinations paying special attention to the pancreatic size (atrophy or enlargement), T1- and T2-signal intensity of the pancreas, focal pancreatic lesion, capsule-like rim, peripancreatic edema or fluid, fascial thickening, and pancreatic ducts (dilatation or narrowing). The results are expressed as percentages. Three groups were compared using Pearson chi-square test for each feature. However, only p-value for “dilatation of the pancreatic duct” was determined, whereas p-value could not be calculated because of the insufficient number of subjects/sequences for the other features.Results
Twelve PSC patients (41.3%) had pancreatic abnormalities. The most common pancreatic changes in PSC patients were decreased T1-signal intensity (44%) and dilatation of the pancreatic duct (13.8%), respectively. Increased T2-signal intensity was also shown in 2 PSC patients (6.9%).Conclusion
Even PSC patients without any sign of pancreatitis, can show MR changes in the pancreatic parenchyma or the pancreatic duct. The etiologies of these changes, and whether they are unique to PSC, are still controversial. Histopathological studies bringing light to these pancreatic changes are needed. 相似文献2.
Engy Yousry ElSayed Amal Amin Abu El Maati Mohamed Mahfouz 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
The aim of the study
To evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography in patients with cholestatic jaundice.Patients and methods
Clinical, laboratory and investigational data were evaluated from 50 patients with cholestastic jaundice. MRCP findings were compared with ERCP or operative findings and appropriate clinical endpoints.Results
The ERCP or operative findings and appropriate clinical endpoints revealed 23 patients with intra or extra hepatic biliary dilatation and 27 patients without intra or extra hepatic biliary dilatation. As regards the 23 patients with biliary dilatation, biliary dilatation was evident in 19 patients by U/S versus 23 patients by MRCP. ERCP was successful in 20 patients (87%) and was not done in three patients (13%). In cases of obstructive jaundice the sensitivity of MRCP was 100% versus 86% in choledocholithiasis and malignant detection, respectively p value <0.05.Conclusion
MRCP is highly sensitive and specific for biliary dilatation and avoids the need for invasive imaging in most patients with cholestasis. MRCP permits reservation of ERCP to patients with a high probability of therapeutic intervention. 相似文献3.
Beswick DM Miraglia R Caruso S Marrone G Gruttadauria S Zajko AB Luca A 《European journal of radiology》2012,81(9):2089-2092
Purpose
To identify the diagnostic value of ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) in diagnosing biliary strictures after liver transplantation.Materials and methods
Sixty patients with clinically suspected biliary strictures after liver transplantation were retrospectively evaluated. All patients underwent US and MRCP before the standard of reference (SOR) procedure: endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. Radiological images were analyzed for biliary dilatation and strictures.Results
By SOR, biliary dilatation was present in 55 patients, stricture in 53 (44 anastomotic, 4 intrahepatic, 5 both), and dilatation and/or stricture in 58. Dilatation was diagnosed by US and MRCP in 39 and 45, respectively (sensitivity 71% vs. 82%, p = 0.18). Stricture was diagnosed by US and MRCP in 0 and 42, respectively (sensitivity 0% vs. 79%, p < 0.0001). False positive stricture was diagnosed by MRCP in 2. Dilatation and/or stricture was diagnosed by US in 39 and MRCP in 50 (sensitivity 67% vs. 86%, p = 0.01); however, using both techniques, sensitivity increased to 95%.Conclusions
MRCP is superior to US for diagnosing biliary strictures after liver transplantation primarily because MRCP can detect stricture. The combination of US and MRCP seems superior to either method alone. Our data suggest that in patients with normal US and MRCP, direct cholangiography could be avoided. 相似文献4.
Xu X Wei X Ling Q Wang K Bao H Xie H Zhou L Zheng S 《European journal of radiology》2012,81(4):e457-e460
Backgrounds and aims
Accurate assessment of graft bile duct is important to plan surgical procedure. Magnetic resonance cholangiopancreatography (MRCP) has become an important diagnostic procedure in evaluation of pancreaticobiliary ductal abnormalities and has been reported as highly accurate. We aim to estimate the efficacy of preoperative MRCP on depicting biliary anatomy in living donor liver transplantation (LDLT), and to determine whether inaccurate preoperative imaging assessment would increase the biliary complications after LDLT.Methods
The data of 118 cases LDLT were recorded. Information from preoperative MRCP was assessed using intraoperative cholangiography (IOC) as the gold standard. The possible risk factors of recipient biliary complications were analyzed.Results
Of 118 donors, 84 had normal anatomy (type A) and 34 had anatomic variants (19 cases of type B, 9 cases of type C, 1 case of type E, 2 cases of type F and 3 cases of type I) confirmed by IOC. MRCP correctly predicted all 84 normal cases and 17 of 34 variant cases, and showed an accuracy of 85.6% (101/118). The incidence of biliary complications was comparable between cases with accurate and inaccurate classification of biliary tree from MRCP, and between cases with normal and variant anatomy of bile duct. While cases with graft duct opening ≤5 mm showed a significant higher incidence of total biliary complications (21.1% vs. 6.6%, P = 0.028) and biliary stricture (10.5% vs. 1.6%, P = 0.041) compared with cases with large duct opening >5 mm.Conclusion
MRCP could correctly predict normal but not variant biliary anatomy. Inaccurate assessment of biliary anatomy from MRCP not increases the rate of biliary complications, while small-sized graft duct may cause an increase in biliary complications particularly biliary stricture after LDLT. 相似文献5.
Rania A. Maarouf Dalia Z. ZidanMaha A. El-Shinnawy 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
Purpose
To investigate the added value of diffusion-weighted imaging (DWI) to magnetic resonance cholangiopancreatography (MRCP) in differentiating benign from malignant extrahepatic biliary strictures.Methods
Magnetic resonance examination including, T2-weighted imaging, MRCP and DWI using different b-values (0,500,800 s/mm2) were performed in 38 patients with suspicious extrahepatic biliary strictures. Apparent diffusion coefficient (ADC) value was calculated. The signal intensity of the lesions on DWI using b = 500 and 800 s/mm2 was examined. Analysis of the DWI and MRCP images for the cause of the extrahepatic biliary stricutre was performed. Patients were further confirmed by histopathological diagnosis and follow up. Sensitivity, specificity, accuracy, positive predictive and negative predictive values were calculated for both the MRCP images and DWI.Results
Of the 38 cases, 23 cases had malignant extrahepatic biliary strictures and 15 had benign strictures. DWI detected 21 out of the 23 malignant biliary strictures and 14 out of 15 benign biliary strictures. Malignant strictures more frequently appeared hyperintense than benign strictures on DWI using b-values of 500 and 800 s/mm2. There was a significant difference in sensitivity (91.3% vs. 73%), specificity (93.3% vs. 64.7%), accuracy (92.1% vs. 73.6%), positive predictive value (95.4% vs. 81%), and negative predictive value (87.5% vs. 64.7%) between DWI and MRCP in differentiating biliary strictures.Conclusion
Combined evaluation using DWI added to MRCP improves the differentiation of malignant from benign extrahepatic biliary strictures. 相似文献6.
Purpose
The aim of this retrospective study is to evaluate the role of T2-weighted MR imaging (MRI) and MR cholangiopancreatography (MRCP) findings in the diagnosis of primary biliary cirrhosis (PBC).Materials and methods
The following T2-weighted MRI and MRCP findings: segmental hepatic atrophy/hypertrophy, irregular liver surface, parenchymal lace-like fibrosis, rounded low signal intensity lesions centering portal vein branches (periportal halo sign), periportal hyperintensity (cuffing), splenomegaly, ascites, lymphadenopathy, venous collaterals, and the configuration of intrahepatic biliary ducts were reviewed for their diagnostic significance by two observers in 13 female patients (mean age: 49 years) with PBC. Discordant readings of the observers were resolved at consensus.Results
When parenchymal lace-like fibrosis and periportal halo sign were seen together the sensitivity of T2-weighted MR images was 69%. In six cases periportal hyperintensity (cuffing) and periportal halo sign were seen together. Segmental hypertrophy was present in nine patients and hepatic surface irregularity due to regenerative nodules were present in 10 patients. Lymphadenopathy was seen in 10, splenomegaly was seen in 5, collateral vascular structures were seen in 2 and minimal perihepatic free fluid was seen in 2 patients. MRCP images revealed various mild irregularity in the intrahepatic bile ducts in 8 patients and focal narrowing at the common bile duct level in 1 patient.Conclusion
MRI and MRCP may support the clinical and laboratory findings of PBC even in the early stages of the disease. MRI can also be a choice of method for the recommended prolonged follow up. 相似文献7.
Sonja Kinner Alexander DechêneAndreas Paul Lale UmutluSusanne C. Ladd Evelin Maldonado de DechêneThomas Zöpf Guido GerkenThomas C. Lauenstein 《European journal of radiology》2011,80(2):e20
Purpose
Two different forms of biliary anastomosis can be created in patients undergoing liver transplantation: (a) bilio-digestive anastomoses or (b) choledocho-choledochostomy. Aim of this study was to assess the accuracy of MR cholangiopancreatography (MRCP) for the depiction of biliary stenoses in liver transplant patients depending on the type of biliary anastomosis.Method and materials
24 liver transplant patients with clinical suspicion of biliary stenosis were studied (each 12 with bilio-digestive anastomosis/choledocho-choledochostomy). MRCP was performed on a 1.5T scanner (Magnetom Avanto, Siemens) including 2D single shot RARE, 2D T2w HASTE, TrueFISP and 3D high-resolution navigator corrected sequences. Presence of (a) anastomotic stenoses (AST) and (b) NAS (non-anastomotic strictures) were assessed. Percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP) were performed within 48 h after MRCP and served as the standard of reference.Results
In patients with bilio-digestive anastomoses sensitivities of MRCP for the detection of AST and NAS amounted to 50% and 67%, respectively with specificity values of 83% and 50%. In patients with choledocho-chledochostomy sensitivities (AST: 100%, NAS: 100%) and specificities (AST: 100%, NAS: 88%) were significantly higher.Conclusion
Biliary strictures after liver transplantation can be accurately detected by MRCP in patients after choledocho-chledochostomy. However, the diagnostic value of MRCP is lower if liver transplantation was performed in combination with a bilio-digestive anastomosis. This may be due to the less exact depiction of the anastomosis in the bowel wall. Thus, it is crucial to know the type of biliary anastomosis before choosing a diagnostic procedure. 相似文献8.
Objective
To determine the utility of CT cholangiography (CT-Ch) in preoperative evaluation of the biliary anatomy of living-donor liver transplantation (LDLT) donors when magnetic resonance cholangiopancreatography (MRCP) is inconclusive.Materials and methods
Over a 2-year period, 22 potential living liver donors underwent contrast-enhanced CT-Ch for preoperative evaluating biliary anatomy due to inconclusive results on MRCP and subsequently donated their right hepatic lobe. Nineteen of them underwent intraoperative cholangiography and were included in this study. Two radiologists retrospectively reviewed both MRCP and CT-Ch with 1-month interval and documented the types of bile duct branching patterns and visualization score of intrahepatic bile ducts (4-point scale).Results
There were no complications associated with CT-Ch examinations. CT-Ch was concordant with the reference standard in 18/19 (95%) including 7/8 typical branching type and 11/11 anomalous branching types. MRCP was concordant with the reference standard in 14/19 (74%) including 4/8 typical branching types and 10/11 anomalous branching types. The discordant case by CT-Ch was the identification of a tiny accessory right intrahepatic duct joining the common bile duct which was not visualized on intraoperative cholangiography. CT-Ch showed higher visualization score (mean, 3.9) than MRCP (mean, 2.6) (P < .001).Conclusion
CT-Ch can be effectively used for the depiction of the branching pattern of the bile duct at the hepatic hilum when MRCP is inconclusive. 相似文献9.
Gensuke Akaike Mitsutomi Ishiyama Shoko Suzuki Yoshiyuki Fujita Sachiko Ohde Yukihisa Saida 《European journal of radiology》2013
Objectives
To evaluate usefulness of peribiliary oedema on computed tomography (CT) in diagnosing acute cholangitis and assessing its severity.Materials and methods
Sixty patients (male 59%, mean age 67.3 years) who underwent endoscopic retrograde biliary drainage (ERBD) for suspected biliary obstruction within 6 h after contrast-enhanced CT were evaluated. Two radiologists performed a consensus evaluation of CT for the presence of peribiliary oedema. Patients were divided into the cholangitis group and the non-cholangitis group based on clinical and ERBD findings, and CT results were compared between the two groups. In the cholangitis group, laboratory values and blood culture results were compared between those with and without peribiliary oedema. Chi-squared test was used for analyses.Results
Of 60 enrolled patients, there were 46 patients in the cholangitis group and 14 patients in the non-cholangitis group. Peribiliary oedema was seen in 24/46 (52.2%) patients in the cholangitis group and 3/14 (23.3%) patients in the non-cholangitis group (p = 0.043). In the cholangitis group, positive blood culture was seen in 12/24 (50%) patients with peribiliary oedema and 4/22 (18.1%) patients without it (p = 0.03).Conclusions
Peribiliary oedema appears to be useful for diagnosis and severity assessment of acute cholangitis. 相似文献10.
Zhang ZY Wang D Ni JM Yu XR Zhang L Wu WJ Gong L Hu MH 《European journal of radiology》2012,81(5):830-837
Purpose
The purpose of our study was to compare three-dimensional (3D) negative-contrast CT cholangiopancreatography (3D-nCTCP) with 3D MR cholangiopancreatography (3D-MRCP) for the diagnosis of obstructive biliary diseases.Materials and methods
3D-nCTCP and 3D-MRCP were performed on seventy clinically documented obstructive biliary diseases patients. The accuracy of each technique in determining the location and cause of biliary obstruction was evaluated compared with the final clinical diagnoses.Results
Both methods achieved 100% of accuracy in the diagnosis of the presence and location of biliary obstruction, and had a similar sensitivity, specificity, accuracy in differentiating benign from malignant biliary obstruction or calculous from noncalculous biliary obstruction (p > 0.05). At 3D-nCTCP, six patients with stones were misinterpreted as cholangitis (N = 2), papillitis (N = 3), or bile duct adenocarcinoma (N = 1); two metastases were mistaken as acute pancreatitis or pancreatic head carcinomas, and one intrahepatic cholangiocarcinoma was misled as bile duct adenoma. At 3D-MRCP, one small stone, one ampullary adenoma, and one intrahepatic cholangiocarcinoma were mistaken as cholangitis, ampullary stone, and intrahepatic bile duct stone, respectively, and three gallbladder carcinomas and another intrahepatic cholangiocarcinoma were misdiagnosed as hilar cholangiocarcinoma (N = 3) or common hepatic duct stone (N = 1); four metastases were mistaken as pancreatic head carcinomas (N = 3) or distal cholangiocarcinoma (N = 1). The overall accuracy in making specific diagnosis of the cause of biliary obstruction was 87.1% for 3D-nCTCP and 84.3% for 3D-MRCP, respectively, (p > 0.05).Conclusion
3D-nCTCP has the similar effects as 3D-MRCP for the diagnosis of biliary obstruction and, the location and the cause of biliary obstruction. In view of selected cases contraindications for MRI, 3D-nCTCP is a potential substitute. 相似文献11.
S. Palmucci L.A. Mauro S. La Scola S. Incarbone G. Bonanno P. Milone A. Russo G.C. Ettorre 《La Radiologia medica》2010,115(5):732-746
Purpose
This study compared the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) in evaluating the cause of extrahepatic bile duct dilatation.Materials and methods
Forty-five patients (26 men, mean age 57 years) with extrahepatic biliary dilatation, as shown by transabdominal ultrasound, with or without elevated biliary and pancreatic serum indices, were prospectively studied with MRCP and EUS between September 2007 and October 2008. EUS and MRCP were performed within no more than 24 h of each other to reduce the possibility of changes due to stone migration. Image analysis was carried out in a double-blind fashion.Results
MRCP had 88.9% diagnostic accuracy, 91.9% sensitivity and 75% specificity, with 94.4% positive predictive value and 66.7% negative predictive value. EUS had 93.3% diagnostic accuracy, 97.3% sensitivity and 75% specificity; the positive and negative predictive values were 94.7% and 85.7%, respectively.Conclusions
MRCP and EUS do not show significant statistical differences in diagnostic accuracy. MRCP is an accurate, noninvasive modality in the study of extrahepatic biliary pathology. EUS is especially reliable in patients with extrahepatic biliary obstruction caused by endoluminal sludge. 相似文献12.
Magnetic resonance cholangiopancreatography (MRCP) is the most important diagnostic alternative that has been developed in recent years for the evaluation of the biliary and pancreatic ducts. The advantages of this technique are: it does not use contrast media or ionizing radiation; it is noninvasive and complication free; and, the examination is relatively short (approximately 20 to 30 minutes). MRCP has high sensitivity and specificity for diagnosing biliary dilatation and for determining the site and cause of stenosis. Its diagnostic precision for biliary and pancreatic stones is similar to that of endoscopic retrograde cholangiopancreatography (ERCP). MRCP has replaced ERCP in biliary and pancreatic anatomic variants. In unsuccessful ERCP, MRCP is nearly the only diagnostic modality for the evaluation of the biliary tract. Other applications include primary sclerosing cholangitis, stenosis after liver transplantation, and the evaluation of bilioenteric anastomoses. This article reviews the clinical applications of MRCP in the evaluation of biliopancreatic diseases. 相似文献
13.
Purpose
To assess the clinical usefulness of free-breathing 3D MRCP in non-cooperative patients compared conventional breath-hold 2D MRCP.Materials and methods
We performed FB navigator-triggered 3D MRCP using prospective acquisition correction and BH 2D MRCP in 48 consecutive, non-cooperative patients among 772 patients. Thirteen patients had malignant obstruction. Two radiologists independently graded the likelihood of a malignant obstruction, the overall image quality, and the visibility of ten, individual anatomic segments of both the biliary and pancreatic duct in each sequence. The area under the ROC curve and the repeated measures analyses of variance with multiple comparisons were used for the comparison. The κ statistics were used for interobserver agreement.Result
The diagnostic performance for detecting malignancy was significantly higher on FB MRCP (Az = 0.962) than on either BH SS-RARE (Az = 0.820, P < 0.0185) or MS-HASTE MRCP (Az = 0.816, P < 0.0067). Interobserver agreement was excellent for FB MRCP (κ = 0.889) and fair for both BH SS-RARE (κ = 0.578) and MS-HASTE MRCP (κ = 0.49). FB MRCP had a significantly higher technical quality than BH MRCP (P < 0.001). FB MRCP was seen to have statistically better visibility of peripheral IHD, right main IHD, CHD, cystic duct, and CBD than BH MRCP (P < 0.001). FB MRCP and BH SS-RARE MRCP had statistically better visibility of both the left main IHD and pancreatic duct than did BH MS-HASTE MRCP (P < 0.001).Conclusion
FB 3D MRCP is useful for non-cooperative patients in whom conventional BH 2D methods cannot be used successfully. 相似文献14.
Bilgin M Balci NC Erdogan A Momtahen AJ Alkaade S Rau WS 《AJR. American journal of roentgenology》2008,191(1):228-232
OBJECTIVE: The purpose of this article is to describe the spectrum of MRI and MR cholangiopancreatography (MRCP) findings of hepatic, pancreatic, and biliary manifestations in patients with HIV infection. CONCLUSION: The spectrum of MRI and MRCP findings in HIV-infected patients includes acute or chronic hepatitis (or both), pancreatitis, cholangitis, acalculous cholecystitis, and biliary strictures that may resemble primary sclerosing cholangitis. The presence of segmental extrahepatic biliary strictures is characteristic of AIDS cholangiopathy. 相似文献
15.
Purpose
The purpose of this study is to assess the common MRI findings of acute cholangitis compared with those of non-acute cholangitis.Materials and methods
During a 31-month period, we performed MRCP and contrast-enhanced MRI on 173 patients with biliary abnormalities including duct dilatation or stricture. The causes of the biliary abnormalities included biliary stone disease (n = 85), cholangiocarcinoma (n = 47), periampullary cancer (n = 20), GB cancer (n = 4), and others (n = 17). Among 173 patients, 66 consecutive patients were confirmed with acute cholangitis diagnosed according to the Tokyo guideline, and 107 patients were confirmed as having non-acute cholangitis. Two radiologists retrospectively and independently accessed the MR findings, including the cause of biliary abnormality, increased periductal signal intensity on T2-weighted images, the transient periductal signal difference, and the presence of abscess, thrombosis, and ragged duct. They also measured the dilated duct and the thickened wall. The Student t-test and the Pearson chi-square were used. The κ statistics were used to determine interobserver agreement. Logistic regression was used to identify the MR findings that predicted acute cholangitis.Results
MRI correctly accessed the cause of biliary abnormality in 163 patients (94%). The statistically common findings for acute cholangitis were as follows: increased periductal signal intensity on T2-weighted imaging (n = 26, 39%, p < 0.05); transient periductal signal difference (n = 31, 47%, p < 0.05); abscess (n = 18, 27%, p < 0.05); thrombosis (n = 12, 18%, p < 0.05); and ragged duct (n = 11, 17%, p < 0.05). Interobserver agreement was good to excellent for each finding (κ = 0.74–0.97). The wall thickness showed a statistically significant difference between the acute cholangitis and the non-acute cholangitis group (2.65 mm:2.32 mm, p < 0.05), however, there was no significant difference in duct dilatation in the two groups. The periductal transient attenuation difference was an independent predictor of acute cholangitis (Exp (B) = 6.389, p = 0.018).Conclusion
MRI accurately assesses the cause of biliary abnormality in patients with cholangitis. Using statistically common MR findings for acute cholangitis, MR imaging is very successful in predicting acute cholangitis. 相似文献16.
Nagle SK Busse RF Brau AC Brittain JH Frydrychowicz A Iwadate Y Reeder SB 《Journal of magnetic resonance imaging : JMRI》2012,36(4):890-899
Purpose:
To determine optimal delay times and flip angles for T1‐weighted hepatobiliary imaging at 1.5 Tesla (T) with gadoxetic acid and to demonstrate the feasibility of using a high‐resolution navigated optimized T1‐weighted pulse sequence to evaluate biliary disease.Materials and Methods:
Eight healthy volunteers were scanned at 1.5T using a T1‐weighted three‐dimensional (3D)‐SPGR pulse sequence following the administration of 0.05 mmol/kg of gadoxetic acid. Navigator‐gating enabled acquisition of high spatial resolution (1.2 × 1.4 × 1.8 mm3, interpolated to 0.7 × 0.7 × 0.9 mm3) images in approximately 5 min of free‐breathing. Multiple breath‐held acquisitions were performed at flip angles between 15° and 45° to optimize T1 weighting. To evaluate the performance of this optimized sequence in the setting of biliary disease, the image quality and biliary excretion of 51 consecutive clinical scans performed to assess primary sclerosing cholangitis (PSC) were evaluated.Results:
Optimal hepatobiliary imaging occurs at 15–25 min, using a 40° flip angle. The image quality and visualization of biliary excretion in the PSC scans were excellent, despite the decreased liver function in some patients. Visualization of reduced excretion often provided diagnostic information that was unavailable by conventional magnetic resonance cholangiopancreatography (MRCP).Conclusion:
High‐resolution navigated 3D‐SPGR hepatobiliary imaging using gadoxetic acid and optimized scan parameters is technically feasible and can be clinically useful, even in patients with decreased hepatobiliary function. J. Magn. Reson. Imaging 2012;36:890–899. © 2012 Wiley Periodicals, Inc. 相似文献17.
Gihan Hassan Gamal 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(2):339-345
Aim of the work
The aim of this study was to assess the utility of non-enhanced MRCP in reduction of biliary complications in LDLT donors and compare the results with IOC.Patients and methods
A total of 54 potential donors with preoperative MRCP (45 males, 9 females, age range 22–51 years). A total of 50 donors underwent right lobe resection and had IOC for comparison. The MRCP and IOC reports were reviewed.The MRCP was performed on 1.5 T MR magnets. Specificity, sensitivity and accuracy were analyzed and compared with IOC findings.Result
A total of 50 donors underwent MRCP and IOC.The findings were classified according to Yoshida et. al.’s study: 42.6% with type 1, 5.6% with type 2, 25.9% with type 3, 7.4% with type 4, and 18.5% with type 8. In comparison with MRCP findings with the golden standard IOC, the sensitivity, specificity and the diagnostic accuracy of MRCP were calculated:Sensitivity was of 88.2%), specificity was of 94.2% and accuracy was of 92%.Conclusion
Biliary complications remain common in LDLT. MRCP has potential in preoperative biliary evaluation for LDLT donors to minimize the postoperative biliary complications.Further improvements of MRCP in LDLT are required to increase its quality and accuracy. 相似文献18.
Filippone A Ambrosini R Fuschi M Marinelli T Pinto D Maggialetti A 《La Radiologia medica》2003,105(1-2):27-35
PURPOSE: To evaluate the role of MR Cholangiopan-creatography (MRCP) as a first imaging modality in patients with suspected biliary tree pathology and indications to endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: Eighty-eight patients, with clinical signs of biliary tree pathology underwent MRCP, performed with a 1.5 T unit and a phased-array coil. Surgery, intraoperative cholangiography, percutaneous transhepatic cholangiography (PTC) or ERCP were regarded as the gold standard in patients with obstruction; the remaining patients underwent follow-up MRCP examinations at 6-9 months. The MR examination was performed with baseline T1w 2D FLASH and T2w TSE sequences, followed by the MRCP study (single-slab breath-hold RARE and multislice breath-hold HASTE sequences). The MR images were independently evaluated by two radiologists. RESULTS: MRCP showed normal findings in 20 patients; 68 patients had biliary duct dilatation. In 11 out of 68 patients MRCP did not identify any obstruction (9/11 were true negative cases). A diagnosis of benign obstruction was expressed in 36/59 patients (4 chronic pancreatitis, 29 choledocolithiasis, 4 inflammatory obstruction, 2 primary sclerosing cholangitis), with 1 false positive and 5 false negatives (sensitivity, specificity and diagnostic accuracy of 86%, 95% and 90%, respectively). MRCP identified 23 neoplastic stenoses (20/23 were true positives): the sensitivity, specificity and diagnostic accuracy values were 100%, 87% and 95%, respectively. MRCP correctly identified the level of obstruction in 100% of cases. CONCLUSIONS: MRCP may be considered as a first-step imaging method in patients with clinical signs of biliary disease. The workload of ERCP in the diagnostic stage could therefore be reduced and its use be reserved for therapeutic indications. 相似文献
19.
Nadine R. Barsoum Ahmed Abdel Samie Lamia Adel Ramy E. Asaad 《The Egyptian Journal of Radiology and Nuclear Medicine》2013
Introduction
Liver transplantation can be done by three different methods: Cadaveric, heterotopic and living donor liver transplantation (LDLT). In LDLT usually the right lobe of a donor liver is transplanted into the patient after proper volumetric studies. The native patient bile ducts are connected to the biliary tree of the transplanted liver segment.Patients and methods
From January 2010 to August 2011, 50 potential LDLT donors were evaluated with preoperative MRCP.Results
The radiologist evaluated the visualization of the common duct, right and left intra-hepatic ducts, and insertion of the right posterior lobe duct. The data were classified according to Huang and Hakki classifications. According to the more detailed classification of Hakki 13 patients (26%) were Type K1; 15 patients (30%) were Type K2a; three patients (6%) were Type K2b; 11 patients (22%) Type K3a; four patients (8%) were Type K3b; two patients (4%) were Type K4 and no patients were Type K5. Two patients with unclassified anatomical biliary pattern were encountered. In conclusion, this study has shown an extremely high accuracy of MRCP in preoperative assessment of live hepatic donors, which aided in the style and procedure of the operation and ultimately to a high success rate of the transplantation procedures. 相似文献20.
S. Maurea O. Caleo C. Mollica M. Imbriaco P.P. Mainenti C. Palumbo M. Mancini L. Camera M. Salvatore 《La Radiologia medica》2009,114(3):390-402