title: MR evaluation of biliary-enteric anastomotic stricture: does contrast-enhanced T1W MRC provide additional information?
abstract: OBJECTIVE
  To compare T2W-MRCP and T1W contrast-enhanced MRC (CE-MRC) using Gd-BOPTA for evaluation of biliary-enteric anastomotic (BEA) stricture.
  
  
  METHODS
  Twenty-one patients who were suspected to have BEA stricture underwent T2W-MRCP and CE-MRC on a 1.5T scanner. Images were evaluated for evidence of anastomotic stricture. Composite gold standard was used including the findings on percutaneous transhepatic cholangiogram or percutaneous transhepatic biliary dilatation, surgery, alkaline phosphatase level and clinical follow-up.
  
  
  RESULTS
  The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of T2W-MRCP for the diagnosis of anastomotic stricture were 94.4%, 80%, 94.4% and 80% respectively. On CE-MRC, biliary excretion was seen in only 60.87% anastomoses and only these were taken for analysis. The sensitivity, specificity, PPV and NPV of CE-MRC for the diagnosis of anastomotic stricture were 40%, 75%, 80% and 33.3%. The combined evaluation of T2W-MRCP and CE-MRC showed sensitivity, specificity, PPV and NPV of 83.3%, 80%, 93.8% and 57.1%.
  
  
  CONCLUSIONS
  At present, T2W-MRCP is still the diagnostic modality of choice in the evaluation of patients with BEA stricture and the usage of Gd-BOPTA enhanced MRC is inappropriate in this setting.
authors: All India Institute of Medical Sciences, Department of Radiodiagnosis, Ansari Nagar, 110029 New Delhi, India. devammc@yahoo.co.in
authors: Devasenathipathy
authors: D
authors: Kandasamy
authors: Raju
authors: R
authors: Sharma
authors: Ashu
authors: A
authors: Seith Bhalla
authors: Shivanand R
authors: SR
authors: Gamanagatti
authors: Deep N
authors: DN
authors: Srivastava
authors: Peush
authors: P
authors: Sahni
authors: Rakesh
authors: R
authors: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery*; D002758:Cholangiography / Q000379:methods*; D003251:Constriction, Pathologic / Q000175:diagnosis; D003287:Contrast Media; D005260:Female; D006801:Humans; D007422:Intestines / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies
chemical_list: D003287:Contrast Media