title: Detection of active bile leak with Gd-EOB-DTPA enhanced MR cholangiography: comparison of 20-25 min delayed and 60-180 min delayed images.
abstract: OBJECTIVE
  The purpose of this study was to assess the value of contrast-enhanced magnetic resonance cholangiography (MRC) performed in different time delays after injection of gadoxetic acid disodium (Gd-EOB-DTPA) for the diagnosis of active bile leak.
  
  
  METHODS
  This retrospective analysis included Gd-EOB-DTPA enhanced MR images of 34 patients suspected of bile leak. Images were acquired 20-25 min after Gd-EOB-DTPA injection. If there was inadequate contrast in the bile ducts then delayed images after 60-90 min and 150-180 min were obtained. Results were correlated with intraoperative findings, ERCP results, clinical data, laboratory tests, and follow-up examinations.
  
  
  RESULTS
  Gd-EOB-DTPA enhanced MRC yielded an overall sensitivity of 96.4%, specificity of 100% and accuracy of 97.1% for the diagnosis of an active bile leak. The sensitivity of 20-25 min delayed MR images was 42.9%, of combined 20-25 min and 60-90 min delayed images was 92.9% and of combined 20-25 min, 60-90 min and 150-180 min delayed images was 96.4%.
  
  
  CONCLUSIONS
  Gd-EOB-DTPA enhanced MRC utilizing delayed phase images was effective for detecting the presence and location of active bile leaks. The images acquired 60-180 min post-injection enabled identification of bile leaks even in patients with a dilated biliary system or moderate liver dysfunction.
authors.affiliation: 2nd Department of Clinical Radiology, Medical University of Warsaw, ul. Banacha 1A, 02-097 Warszawa, Poland. Electronic address: andrzej.cieszanowski@wum.edu.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Cieszanowski
authors.forename: Anna
authors.initials: A
authors.lastname: Stadnik
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Lezak
authors.forename: Edyta
authors.initials: E
authors.lastname: Maj
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zieniewicz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Rowinska-Berman
authors.forename: Ireneusz P
authors.initials: IP
authors.lastname: Grudzinski
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
authors.forename: Olgierd
authors.initials: O
authors.lastname: Rowiński
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000473:pathology*; D001660:Biliary Tract Diseases / Q000473:pathology*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Bile duct injury; Bile leak; MR contrast agents; MR imaging; MRCP