Anatomic variants of the biliary tree: diagnosis with MR cholangiopancreatography.
OBJECTIVE
To evaluate the accuracy of magnetic resonance (MR) cholangiopancreatography in the diagnosis of anatomic variants of the biliary tree.


METHODS
In 171 patients, the anatomy of the biliary tree was evaluated with MR cholangiopancreatography. Two independent reviewers evaluated the presence of anatomic variants. Contrast material-enhanced cholangiography that was previously performed opacified the cystic duct in 77 patients and the bile duct bifurcation in 93 patients, and was chosen as the standard of reference in the diagnosis of anatomic variants.


RESULTS
MR cholangiopancreatography demonstrated the cystic duct in 126 patients (74%). MR cholangiopancreatography showed a low cystic duct insertion in 11 patients (9%), a medical cystic duct insertion in 22 patients (17%), and a parallel course of the cystic and hepatic ducts in 31 patients (25%). The bile duct bifurcation was demonstrated in 139 patients (81%), and an aberrant right hepatic duct was demonstrated in 12 patients (9%).


CONCLUSIONS
MR cholangiopancreatography is accurate in the diagnosis of anatomic variants of the biliary tree that may increase the risk of bile duct injury during laparoscopic cholecystectomy.
Taourel
P
P
Department of Diagnostic Radiology, Montreal General Hospital, McGill University, Montreal, Quebec, Canada.
Bret
P M
PM
Reinhold
C
C
Barkun
A N
AN
Atri
M
M
D001652:Bile Ducts / Q000033:anatomy & histology* / Q000293:injuries; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D003549:Cystic Duct / Q000033:anatomy & histology*; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005260:Female; D006500:Hepatic Duct, Common / Q000033:anatomy & histology*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012307:Risk Factors; D012680:Sensitivity and Specificity