Mangafodipir-enhanced magnetic resonance cholangiography for the diagnosis of bile duct leaks.
BACKGROUND
The purpose of this prospective study was to assess the value of contrast-enhanced magnetic resonance cholangiography with mangafodipir trisodium perfusion for detection and localization of trauma-induced and postoperative bile duct leaks.


METHODS
Eleven patients with suspected bile duct leaks after trauma (n=5) or surgery (n=6) were included. Patients with suspected leaks after cholecystectomy were excluded. All patients underwent contrast-enhanced magnetic resonance cholangiography with two-dimensional axial and three-dimensional coronal gradient-echo images acquired 1 to 3 hours after intravenous administration of mangafodipir trisodium perfusion. Contrast-enhanced magnetic resonance cholangiography findings were correlated with direct cholangiography obtained in all patients, including endoscopic retrograde (n=7) and percutaneous transhepatic cholangiography (n=4).


RESULTS
Biliary tract enhancement was identified in all patients on contrast-enhanced magnetic resonance cholangiography. Peritoneal cavity fluid and bile collections that contained extravasated mangafodipir trisodium (increased signal intensity on gradient-echo sequences) were demonstrated in 6 patients. Direct cholangiography confirmed the presence of bile duct leaks in these 6 patients and the absence of bile duct leaks in 5 patients. There was no false-negative or false-positive contrast-enhanced magnetic resonance cholangiography.


CONCLUSIONS
Mangafodipir-enhanced magnetic resonance cholangiography is a noninvasive technique that can provide functional biliary information with excellent depiction of bile duct leaks.
Pilleul
Frank
F
Département de radiologie digestive, hôpital universitaire E. Herriot, Lyon, France.
Billaud
Yann
Y
Gautier
Guillaume
G
Monneuse
Olivier
O
Crombé-Ternamian
Arielle
A
Fouque
Pascal
P
Valette
Pierre-Jean
PJ
D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000293:injuries / Q000473:pathology*; D003287:Contrast Media; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008345:Manganese; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*
D003287:Contrast Media; D008345:Manganese; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid