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Contrast-enhanced MR cholangiography with Gd-EOB-DTPA in patients with liver cirrhosis: visualization of the biliary ducts in comparison with patients with normal liver parenchyma

Tschirch, Frank ; Struwe, Anja ; Petrowsky, Henrik ; Kakales, Irini ; Marincek, Borut ; Weishaupt, Dominik

In: European Radiology, 2008, vol. 18, no. 8, p. 1577-1586

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    Titre
    • Contrast-enhanced MR cholangiography with Gd-EOB-DTPA in patients with liver cirrhosis: visualization of the biliary ducts in comparison with patients with normal liver parenchyma
    Auteur
    • Tschirch, Frank. Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    • Struwe, Anja. Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    • Petrowsky, Henrik. Department of Visceral and Transplantation Surgery, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    • Kakales, Irini. Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    • Marincek, Borut. Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    • Weishaupt, Dominik. Institute of Diagnostic Radiology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:315516
    Summary
    The purpose of this study was to assess the quality of biliary duct visualization using Gd-EOB-DTPA-enhanced magnetic resonance cholangiography (EOB-MRC) in patients with liver cirrhosis. Forty adult patients with liver cirrhosis (cirrhosis group) and 20 adult individuals with normal liver parenchyma (control group) underwent EOB-MRC using T1-weighted GRE imaging up to 180min after Gd-EOB-DTPA administration. Two observers assessed the visualization of each biliary structure and the overall anatomical visualization of the biliary tree. Child-Pugh, MELD score and laboratory findings were compared. The grade of visualization for each evaluated biliary structure was statistically different in the two groups (P = 0.004 to <0.001). The overall EOB-MRC quality was rated as sufficient for anatomical visualization of the biliary tree in all individuals of the control group 20min after Gd-EOB-DTPA application, but in only 16/40 patients (40%) of the cirrhosis group within 30min after application. Analysis of the ROC curves revealed that the cut-off values, for non-sufficient visualization of the biliary tree 20min after Gd-EOB-DTPA application, were MELD scores ≥11 and total serum bilirubin levels ≥30 μmol/l. Consecutively, EOB-MRC in patients with liver cirrhosis resulted in a decreased or even non-visualization of the biliary tree in a substantial percentage of patients