title: Normal and pathologic features of the postoperative biliary tract at 3D MR cholangiopancreatography and MR imaging.
abstract: Magnetic resonance (MR) imaging with cholangiopancreatographic sequences plays a critical role in evaluating alterations in the biliary tract after surgical procedures such as cholecystectomy, liver transplantation, hepatic resection, and the creation of a biliary-enteric anastomosis. MR cholangiopancreatography, a rapid, noninvasive, and accurate imaging technique for the assessment of early and late complications of hepatobiliary surgery, usually enables the identification of normal and abnormal postoperative changes. In cases of complete obstruction of the bile duct, MR cholangiopancreatography allows analysis of the biliary tract above and below the level of the obstruction, a capability essential for treatment planning and one that is not provided by either endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography. MR cholangiopancreatography is particularly useful for the evaluation of biliary-enteric anastomoses, for which an endoscopic approach is generally precluded. It also can help detect and localize bile duct strictures and stones and can help accurately classify bile duct injuries. It is useful for detecting bile leaks, although it generally does not directly depict the extravasation of bile. In addition to MR cholangiopancreatography, T1- and T2-weighted MR imaging may be performed to depict extrabiliary soft-tissue structures and abnormalities such as an abscess, tumor recurrence or metastasis, hematoma, or hemobilia. Mangafodipir trisodium-enhanced MR cholangiopancreatography, a recently developed technique that provides a combination of anatomic and functional information, is particularly helpful for documenting bile leaks because it allows a functional evaluation of biliary excretion and may directly depict bile leakage from injured ducts.
authors.affiliation: Department of Radiology, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France. christine.hoeffel@sat.ap-hop-paris.fr
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
authors.forename: Louisa
authors.initials: L
authors.lastname: Azizi
authors.forename: Maité
authors.initials: M
authors.lastname: Lewin
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurent
authors.forename: Christophe
authors.initials: C
authors.lastname: Aubé
authors.forename: Lionel
authors.initials: L
authors.lastname: Arrivé
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Tubiana
mesh_terms: D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000601:surgery*; D001652:Bile Ducts / Q000473:pathology* / Q000601:surgery*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'