Imaging of gallbladder and biliary tract before laparoscopic cholecystectomy: comparison of intravenous cholangiography and the combined use of HASTE and single-shot RARE MR imaging.
To compare intravenous cholangiography (i.v.c.) and magnetic resonance imaging (MRI) as preoperative imaging techniques in patients scheduled for laparoscopic cholecystectomy. Twenty patients underwent i.v.c. and MRI, 40 axial 'localizer' images were first obtained with a half-Fourier single-shot turbo spin echo (HASTE) sequence. Next, an extremely high T2-weighted rapid acquisition relaxation enhancement (RARE) acquisition (TE = 1100 msec) was used for MR cholangiography. All images obtained with i.v.c. and MRI were independently analyzed by two observers. The relative visibility of the (normal or abnormal) gallbladder (GB), cystic duct (CD), and bile ducts (BD) on both types of images was scored as follows: 1 = MRI better than i.v.c.; 2 = no difference; 3 = i.v.c. better than MRI. We observed 3 anatomic variants: 1 of the cystic duct and 2 of the intrahepatic bile ducts; 15 patients had gallstones; one had cholecystitis. Magnetic resonance images were considered more informative than i.v.c.-images for visualization of GB in 11 patients (55%), for CD in 9 patients (45%), and in 8 patients (40%) for visualization of the CBD. Intravenous cholangiography outperformed MRI in the evaluation of the CBD and CD in one patient (5%). The combined use of half-Fourier single-shot RARE and high T2-weighted RARE MR imaging is a valuable alternative to i.v.c. in the preoperative evaluation of gallbladder and biliary tract.
Vanbeckevoort
D
D
Department of Radiology, University Hospitals, Leuven, Belgium.
Van Hoe
L
L
Ponette
E
E
Marchal
G
G
Bosmans
H
H
De Clercq
B
B
Aerts
R
R
Baert
A L
AL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D002758:Cholangiography / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic; D003549:Cystic Duct / Q000473:pathology; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care