title: Detection and localization of bile duct leaks after cholecystectomy using Gd-EOB-DTPA-enhanced MR cholangiography: retrospective study of 16 patients.
abstract: OBJECTIVE
  To determine if gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) cholangiography can detect and localize bile duct leaks in postcholecystectomy patients.
  
  
  METHODS
  Four blinded independent radiologists performed a retrospective review of 16 consecutive patients who underwent MR cholangiography with intravenous Gd-EOB-DTPA for the evaluation of possible biliary leak. Image quality, ductal opacification, and presence and location of any bile leak were evaluated. An independent observer determined the criterion standard using a consensus of all chart, clinical, and imaging findings.
  
  
  RESULTS
  All 6 bile leaks confirmed at endoscopic retrograde cholangiopancreatography were diagnosed by all reviewers (sensitivity, 100%). Of the 10 patients with no leak, only one reader incorrectly diagnosed a bile leak in a single case (specificity, 98%). The accuracy for detection of the site of leak with Gd-EOB-DTPA-enhanced MR cholangiography was 80%.
  
  
  CONCLUSIONS
  Gadolinium-EOB-DTPA-enhanced MR can detect bile leaks with a high sensitivity and specificity.
authors.affiliation: *From the Diagnostic Radiology, The Health Sciences Center, University of Manitoba, Winnipeg, Manitoba, Canada; †Diagnostic Radiology, MRI Department, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada; ‡Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and §Diagnostic Radiology, CT Department, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Ratcliffe
authors.forename: Iain D
authors.initials: ID
authors.lastname: Kirkpatrick
authors.forename: V
authors.initials: V
authors.lastname: Anik Sahni
authors.forename: Howard M
authors.initials: HM
authors.lastname: Greenberg
authors.forename: Blair
authors.initials: B
authors.lastname: Henderson
authors.forename: Dejana
authors.initials: D
authors.lastname: Radulovic
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Mottola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis* / Q000209:etiology; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000209:etiology; D001652:Bile Ducts / Q000473:pathology; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D002763:Cholecystectomy / Q000009:adverse effects*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA