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https://hdl.handle.net/11499/7974
Title: | Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: Comparison with T2-weighted MR cholangiography | Authors: | Kantarci, M. Pirimoglu, B. Karabulut, Nevzat Bayraktutan, U. Ogul, H. Ozturk, G. Aydinli, B. |
Keywords: | Biliary leaks Biliary tree Contrast enhanced MRC Gd-EOB-DTPA MR cholangiography gadoxetic acid adult aged article bile leakage cholangiography clinical trial diagnostic accuracy diagnostic test accuracy study diagnostic value endoscopic retrograde cholangiopancreatography female human magnetic resonance cholangiography major clinical study male non invasive procedure postoperative complication priority journal sensitivity and specificity Adult Aged Anastomotic Leak Biliary Tract Diseases Cholangiopancreatography, Magnetic Resonance Contrast Media Diffusion Magnetic Resonance Imaging Gadolinium DTPA Humans Image Enhancement Image Interpretation, Computer-Assisted Male Middle Aged Reproducibility of Results Sensitivity and Specificity |
Abstract: | Objective: To evaluate the added role of T1-weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) compared with T2-weighted MRC (T2w-MRC) in the detection of biliary leaks. Methods: Ninety-nine patients with suspected biliary complications underwent routine T2w-MRC and T1w contrast-enhanced (CE) MRC using Gd-EOB-DTPA to identify biliary leaks. Two observers reviewed the image sets separately and together. MRC findings were compared with those of surgery and percutaneous transhepatic cholangiopancreatography. The sensitivity, specificity and accuracy of the techniques in identifying biliary leaks were calculated. Results: Accuracy of locating biliary leaks was superior with the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC (P < 0.05).The mean sensitivities were 79 % vs 59 %, and the mean accuracy rates were 84 % vs 58 % for combined CE-MRC and T2w-MRC vs sole T2w-MRC. Nineteen out of 21 patients with biliary-cyst communication, 90.4 %, and 12/15 patients with post-traumatic biliary extravasations, 80 %, were detected by the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC images, P < 0.05. Conclusions: Gd-EOB-DTPA-enhanced MRC yields information that complements T2w-MRC findings and improves the identification and localisation of the bile extravasations (84 % accuracy, 100 % specificity, P < 0.05). We recommend Gd-EOB-DTPA-enhanced MRC in addition to T2w-MRC to increase the preoperative accuracy of identifying and locating extravasations of bile. Key Points: • Magnetic resonance cholangiography (MRC) does not always detect bile leakage and cysto-biliary communications. • Gd-EOB-DTPA-enhanced MRC helps by demonstrating extravasation of contrast material into fluid collections. • Gd-EOB-DTPA-enhanced MRC also demonstrates the leakage site and bile duct injury type. • Combined Gd-EOB-DTPA-enhanced and T2w-MRC can provide comprehensive information about biliary system. • Gd-EOB-DTPA-enhanced MRC is non-invasive and does not use ionising radiation. © 2013 The Author(s). | URI: | https://hdl.handle.net/11499/7974 https://doi.org/10.1007/s00330-013-2880-4 |
ISSN: | 0938-7994 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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