[Mangafodipir trisodium-enhanced magnetic resonance cholangiography for detection of bile leaks].
OBJECTIVE
To assess the value of contrast-enhanced magnetic resonance cholangiography with Teslascan perfusion for the detection and localization of trauma-induced and postoperative bile leaks.


METHODS
Between October 2002 and December 2004, 7 patients with suspected bile duct leaks after trauma (n = 2) or surgery (n = 5) requiring morphological evaluation were included. MRI examination included single shot fast spin- echo T2 weighted and gradient echo T1 weighted images prior to and 112 minutes in average after IV administration of mangafodipir trisodium. The results of contrast enhanced MR cholangiography were correlated to surgery (n = 3), clinical course (n = 3) and percutaneous drainage (n = 1).


RESULTS
Mangafodipir trisodium-enhanced imaging showed extravasated Teslascan in collections in 6 patients (86%) whereas the combination of T2 weighted images and mangafodipir trisodium enhanced images revealed biliary collections in 7 patients (100%). The fistula between bile duct and collection was visualized in 4 patients (57%) before mangafodipir trisodium perfusion and in 3 patients (43%) after injection. In one patient the fistula was visible only after injection. Combination of both pre- and post injection MR correctly depicted the origin of bile leak in 5 cases (71%).


CONCLUSIONS
Mangafodipir trisodium-enhanced magnetic resonance cholangiography is a non invasive technique that can successfully detect the presence of bile duct leaks. The combination of T2 weighted MR cholangiography and mangafodipir trisodium-enhanced T1 weighted MR cholangiography increases the sensitivity in detection and localization of the site of bile leak.
Assaban
M
M
Département de Radiologie, CHU Angers.
Aubé
C
C
Lebigot
J
J
Ridereau-Zins
C
C
Hamy
A
A
Caron
C
C
D000007:Abdominal Injuries / Q000150:complications; D000293:Adolescent; D000328:Adult; D000368:Aged; D001646:Bile; D001649:Bile Duct Diseases / Q000175:diagnosis; D001658:Biliary Fistula / Q000175:diagnosis*; D002763:Cholecystectomy / Q000009:adverse effects; D003287:Contrast Media; D004322:Drainage; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008345:Manganese; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media; D008345:Manganese; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid