Coakley FV, Schwartz LH, Blumgart LH, Fong Y, Jarnagin WR, Panicek DM. Complex postcholecystectomy biliary disorders: preliminary experience with evaluation by means of breath-hold MR cholangiography. Radiology 1998 Oct;209(1):141-6
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
PURPOSE: To assess preliminary
experience with breath-hold single-shot fast spin-echo magnetic
resonance (MR) cholangiography in complex postcholecystectomy
biliary disorders. MATERIALS AND METHODS: MR cholangiography was
performed in 17 consecutive patients referred for specialist surgical
evaluation of suspected complex postcholecystectomy biliary disorders.
Two readers, unaware of surgical, histopathologic, or other imaging
findings, independently reviewed the MR cholangiographic images
to assess the presence of biliary occlusion, peribiliary lesions,
nonspecific biliary dilatation (biliary dilatation without an
abrupt transition in caliber and without a visible underlying
cause), bile duct stones, or biliary fistulas. Final diagnoses
were established with surgery (n = 9), imaging other than MR (n
= 6), and histopathologic review of the initial surgical specimen
(n = 2). RESULTS: Final diagnoses were biliary occlusion (n =
8), peribiliary lesions (n = 3), nonspecific biliary dilatation
(n = 3), bile duct stones (n = 2), and biliary-colonic fistula
(n = 1). The two readers correctly categorized these diagnoses
in 15 (88%) and 13 (76%) of the 17 cases, with excellent interobserver
agreement (kappa = 0.82). CONCLUSION: Single-shot fast spin-echo
MR cholangiography is an accurate, noninvasive modality for the
assessment of complex postcholecystectomy biliary disorders.
| Plaies | Dilatations | Calculs |