PURPOSE: To assess the value of MRCP with Mangafodipir Trisodium (Teslascan) injection in the diagnosis and management of bile leaks. PATIENTS AND METHODS: Retrospective study of 25 patients (18 males, 7 females) with a mean age of 49.7 years and high clinical suspicion of bile leak who underwent MRCP with Mangafodipir Trisodium (Teslascan) injection between 2002 and 2006. The suspected etiology for bile leak was surgical (n=17), traumatic (n=7) or medical (n=1). The clinical suspicion was based on a combination of clinical, laboratory and imaging findings. RESULTS: MRCP with Teslascan injection demonstrated a bile leak in 20 patients. The site of leak was depicted in 17 cases: second order of smaller bile duct, (n=9), hepatic duct (n=3), confluence (n=2), cystic duct (n=1), bilioenteric anastomosis (n=2). Management based on MR findings included biloma drainage (n=7), biliary drainage (n=5), endoscopic management (n=2), repeat surgery (n=3), expectant management (n=1), and medical management (n=1). Outcome was favourable in 18 cases. Two patients died from infectious complications. CONCLUSION: In addition to confirming a diagnosis of bile leak, MRCP with Teslascan injection depicts the site of leak allowing optimal management.
PURPOSE: To assess the value of MRCP with Mangafodipir Trisodium (Teslascan) injection in the diagnosis and management of bile leaks. PATIENTS AND METHODS: Retrospective study of 25 patients (18 males, 7 females) with a mean age of 49.7 years and high clinical suspicion of bile leak who underwent MRCP with Mangafodipir Trisodium (Teslascan) injection between 2002 and 2006. The suspected etiology for bile leak was surgical (n=17), traumatic (n=7) or medical (n=1). The clinical suspicion was based on a combination of clinical, laboratory and imaging findings. RESULTS: MRCP with Teslascan injection demonstrated a bile leak in 20 patients. The site of leak was depicted in 17 cases: second order of smaller bile duct, (n=9), hepatic duct (n=3), confluence (n=2), cystic duct (n=1), bilioenteric anastomosis (n=2). Management based on MR findings included biloma drainage (n=7), biliary drainage (n=5), endoscopic management (n=2), repeat surgery (n=3), expectant management (n=1), and medical management (n=1). Outcome was favourable in 18 cases. Two patients died from infectious complications. CONCLUSION: In addition to confirming a diagnosis of bile leak, MRCP with Teslascan injection depicts the site of leak allowing optimal management.