[3D-TSE MR cholangiopancreatography with breath triggering to clarify unclear hepatopathies in children].
OBJECTIVE
Evaluation of 3D-TSE MR-cholangiography with respiratory triggering in the work up of hepatopathies in infants and young children.


METHODS
16 infants (4-16 years) with increased transaminases, two with recurrent pancreatitis, were examined at 1.5 T (ACS-NT II, Philips Medical Systems) using a 3D-TSE MRCP with respiratory triggering in addition to a regular MRI of the liver. The MRCP was compared to ERCP. Two radiologists and one gastroenterologist evaluated the technical quality, visualization of the pancreaticobiliary system, and the diagnostic value of the examinations.


RESULTS
Technically feasible were 14/16 MRCPs and 13/16 ERCPs. Two MRCP were not of diagnostic value due to motion artifacts and in three ERCP cannulation of the papilla was not possible. 14/16 ERCP required general anaesthesia, while MRCP needed i.v. sedation in two patients only. Extrahepatic ducts/cystic duct/pancreatic duct were visualized in 14/12/8 patients using MRCP, and in 13/10/3 patients using ERCP, both without adverse effects or complications. Intrahepatic ducts were better delineated with MRCP. In 10 patients with histologically proven periportal fibrosis (n = 7) and liver fibrosis (n = 1) or antineutrophil cytoplasmatic antibodies and associated inflammatory bowel disease, MRCP and ERCP revealed pathological results.


CONCLUSIONS
MRCP using a 3D-TSE sequence with respiratory triggering is a good non-invasive technique for delineation of the biliary tract in infants and young children for the work up to hepatopathies.
Textor
H J
HJ
Radiologische Universitätsklinik Bonn. Textor@uni-bonn.de
Pauleit
D
D
Flacke
S
S
Keller
E
E
Keller
K M
KM
Neubrand
M
M
Gieseke
J
J
Schild
H H
HH
D000293:Adolescent; D001652:Bile Ducts / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D015588:Observer Variation; D010179:Pancreas / Q000473:pathology*; D012119:Respiration
3D-TSE MR-Cholangiopankreatikographie mit Atemtriggerung zur Abklärung von unklaren Hepatopathien bei Kindern.