Initial experience on utility of gadobenate dimeglumine (Gd-BOPTA) enhanced T1-weighted MR cholangiography in diagnosis of acute cholecystitis.
OBJECTIVE
To investigate the feasibility of the use of gadobenate dimeglumine (also known as Gd-BOPTA) -enhanced T1-weighted MR cholangiography in diagnosis of acute cholecystitis.


METHODS
This prospectively designed institutional review board-approved HIPAA-compliant study was done between January and November 2007. We included 11 consecutive patients (7 male, mean age 59 years) who presented to the emergency room with acute right upper quadrant pain and with equivocal physical examination and/or ultrasound findings. The control group included 15 patients who underwent liver MRI with Gd-BOPTA. All patients underwent contrast-enhanced (CE) MR cholangiography examinations. CE-MR cholangiography was performed on a 1.5 Tesla magnet using 3D T1-weighted high resolution isotrophic volume examination (THRIVE) obtained at the 90th min after intravenous injection of Gd-BOPTA. Imaging features detected on CE-MR cholangiography were correlated with operative and histopathologic findings.


RESULTS
In the control group, GD-BOPTA was visualized within the gallbladder in all subjects. For the study group, gallstones were present in nine patients (n = 7 both in gallbladder and cystic duct, n = 1 only in gallbladder, n = 1 only in cystic duct) on MRCP. Hydropic gallbladder was detected in seven patients, significant wall thickening in seven patients, and pericholecystic free fluid in 6 patients. On delayed phase CE cholangiography, significant enhancement of gallbladder wall was seen in 10 patients, and contrast agent excretion into gallbladder was absent in all patients. Surgery was performed in 10 patients, and cholecystostomy was done in 1 patient. Surgery and histopathology findings were consistent with cholecystitis in all patients.


CONCLUSIONS
In addition to anatomical assessment, Gd-BOPTA-enhanced MR cholangiography can provide functional evaluation similar to HIDA scintigraphy in diagnosing acute cholecystitis in patients with acute right upper quadrant pain and equivocal findings.
Akpinar
Erhan
E
Hacettepe University School of Medicine, Department of Radiology, Ankara, Turkey.
Turkbey
Baris
B
Karcaaltincaba
Musturay
M
Balli
Omur
O
Akkapulu
Nezih
N
Balas
Sener
S
Tirnaksiz
Bulent
B
Akata
Deniz
D
Akhan
Okan
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D041881:Cholecystitis, Acute / Q000175:diagnosis* / Q000601:surgery; D003287:Contrast Media; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D005704:Gallbladder / Q000473:pathology / Q000601:surgery; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D011446:Prospective Studies; D055815:Young Adult
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine