Magnetic resonance cholangiography: Current and future perspectives.
Magnetic resonance cholangiography (MRC) has become the standard of reference for imaging of the biliary ducts. The use of three-dimensional (3D) sequences has resulted in improved spatial resolution with virtually isotropic voxel and improved signal/noise ratio. In addition to MRC images, 3D fat suppressed T1-weighted MR images should be systematically obtained to search for intrahepatic calculi. MRC plays a major role in the diagnosis of cholangiocarcinoma and assessment of its resectability. With modern MR systems the performance of MR is basically the same that of CT for evaluation of arterial and portal vein extent. MRC is a key imaging modality for the diagnosis of primary sclerosing cholangitis. Different imaging patterns may be observed including multifocal intra- and extrahepatic strictures alternating with slightly dilated ducts. Focal signal abnormality of the liver parenchyma and focal parenchymal atrophy represent the consequences of biliary duct obstruction on liver parenchyma. Diagnosis of biliary lithiasis is performed by combination of MRC and T1-weighted MR imaging. MRC can be performed for the diagnosis of secondary cholangitis including ascending cholangitis, ischemic cholangitis and IgG4-related sclerosing cholangitis. Hepatobiliary contrast agents could be used for demonstrating the site of biliary duct leakage after surgery and for functional imaging. MR imaging can also be used to determine the prognosis of PSC. The inherent limitations of MRC of bile ducts are still the suboptimal spatial resolution for evaluation of distal intrahepatic biliary ducts.
Department of Radiology, Sorbonne Universités, UPMC University Paris 06, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. Electronic address: lionel.arrive@sat.aphp.fr.
Lionel
L
Arrivé
Department of Radiology, Sorbonne Universités, UPMC University Paris 06, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Marianne
M
Hodoul
Department of Radiology, Sorbonne Universités, UPMC University Paris 06, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Antoune
A
Arbache
Department of Radiology, Sorbonne Universités, UPMC University Paris 06, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Lucie
L
Slavikova-Boucher
Department of Radiology, Sorbonne Universités, UPMC University Paris 06, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Yves
Y
Menu
Department of Radiology, Sorbonne Universités, UPMC University Paris 06, Saint-Antoine Hospital, Assistance publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Sanaâ
S
El Mouhadi
D001660:Biliary Tract Diseases / Q000175:diagnosis*; D002758:Cholangiography / Q000379:methods* / Q000639:trends; D002761:Cholangitis / Q000175:diagnosis; D005544:Forecasting; D006801:Humans; D008279:Magnetic Resonance Imaging