title: Dynamic MR cholangiography after fatty meal loading: cystic contractility and dynamic evaluation of biliary stasis.
abstract: OBJECTIVE
  Dynamic MR cholangiography was conducted on patients with cholelithiasis or choledocholithiasis who had consumed a fatty test meal (Molyork) and the cystic contractility and dynamics of biliary stasis was evaluated.
  
  
  METHODS
  The subjects were 25 with intracystic cholelithiasis, 10 with choledocholithiasis and 10 normal controls. For an imaging sequence, the rapid acquisition with relaxation enhancement (RARE) method was employed and imaging was conducted for 40 min (every 30 s following Molyork administration) without breath-holding. The gallbladder contraction ratio was computed and the contractile ratio for the common bile duct was calculated. To determine the bile flow to the duodenum, the high-intensity signal, indicating the flow from the lower common bile duct, and perfusion of the duodenum were observed in dynamic mode on the monitor with the naked eye and interpreted as positive bile flow. The frequency of this flow was visually monitored.
  
  
  RESULTS
  The gallbladder contractile ratio was significantly reduced in patients with cholelithiasis or choledocholithiasis compared with the controls. In a comparison with the normal controls, no sequential changes were noted in the mean contractile ratio of the common bile duct of the patients with cholelithiasis or choledocholithiasis. The mean frequency of bile flow observed for each 40 min period was 13+/-2.4, 6+/-2.2, and 4+/-1.3 times for the controls, those with intracystic cholelithiasis, and those with choledocholithiasis, respectively. Compared with the controls, the latter two patient groups showed evident reductions in the frequency of bile flow to the duodenum (p<0.001).
  
  
  CONCLUSIONS
  Dynamic MRC combined with Molyork loading makes it possible to compute cystic contractile ratios and perform a dynamic examination of bile flow under non-invasive, near-physiological conditions.
authors.affiliation: Department of Internal Medicine 5, Tokyo Medical University, Kasumigaura Hospital, 3-20-1 Ami-Machi-Chuoh, Inashikigun, Ibaraki 300-0395, Japan. oma@jd6.so-net.ne.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Omata
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Saito
authors.forename: Fumio
authors.initials: F
authors.lastname: Kotake
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizokami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Abe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D049448:Cholangiopancreatography, Magnetic Resonance; D042883:Choledocholithiasis / Q000503:physiopathology*; D002769:Cholelithiasis / Q000503:physiopathology*; D002779:Cholestasis / Q000503:physiopathology*; D004041:Dietary Fats / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D004041:Dietary Fats