Obliteration of the Biliary System after Administration of an Oral Contrast Medium Is Probably due to Regurgitation: A Pitfall on MRCP.
OBJECTIVE
We retrospectively evaluated the incidence and related factors of obliteration of the lower bile duct after oral administration of contrast medium (OCM) probably resulting from its regurgitation into the biliary system (OCMRB) as observed on images of MR cholangiopancreatography (MRCP).


METHODS
We retrospectively analyzed 305 MRCP images in 278 patients obtained between February 2010 and March 2011 using negative OCM with 1.0- and 1.5-tesla clinical units. OCMRB was defined as positive when visualization of the common bile duct was clear on precontrast 2-dimensional (2D) MRCP but obliterated on postcontrast 3-dimensional (3D) MRCP. Two abdominal radiologists reviewed all images in consensus. The incidence of OCMRB was correlated to various clinicoradiological factors.


RESULTS
We observed OCMRB on 11 MRCP images in 10 patients (3.6%). Among various clinicoradiological factors, the presence of juxtapapillary diverticula, pneumobilia, and history of intervention to the papilla were suggested as significant factors related to positive OCMRB with multivariate analysis (P < 0.05).


CONCLUSIONS
OCMRB occurs in about 4% of the patients who undergo MRCP, typically in those with juxtapapillary diverticula, pneumobilia, and history of papillary intervention. Acquisition of MRCP images before OCM may secure visualization of the common bile duct in these patients.
Department of Radiology, Faculty of Medicine, Fukuoka University.
Keiko
K
Sakamoto
Yoshinobu
Y
Shinagawa
Kimiyo
K
Inoue
Ayako
A
Morita
Hiroshi
H
Urakawa
Ritsuko
R
Fujimitsu
Kouichi
K
Takano
Kengo
K
Yoshimitsu
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology; D016477:Artifacts; D001659:Biliary Tract / Q000473:pathology; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D003135:Common Bile Duct / Q000033:anatomy & histology*; D003137:Common Bile Duct Diseases / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage*; D004240:Diverticulum / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology; D012189:Retrospective Studies
D003287:Contrast Media