Wen-Pei Wu1, Ran-Chou Chen2, Chih-Wei Lee3, Yao-Li Chen4, Kwo-Whei Lee3, Hwa-Koon Wu3, Chen-Te Chou5. 1. Department of Radiology, Lukang Christian Hospital, Chang-Hua, Taiwan, ROC; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC. 2. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan, ROC. 3. Department of Radiology, Chang-Hua Christian Hospital, Chang-Hua, Taiwan, ROC. 4. Transplant Center, Chang-Hua Christian Hospital, Chang-Hua, Taiwan, ROC. 5. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Chang-Hua Christian Hospital, Chang-Hua, Taiwan, ROC. Electronic address: chouchente@yahoo.com.tw.
Abstract
BACKGROUND: Gadoxetic acid is one of the hepatobiliary-specific agents and so can be used for contrast-enhanced magnetic resonance cholangiography (CE-MRC). The aim of our study was to compare the performance of CE-MRC with that of T2-weighted magnetic resonance cholangiography (T2W-MRC), and also to ascertain the effectiveness of both modalities combined for visualizing anatomic structures of the biliary tree in patients with liver cirrhosis. METHODS: Fifty-six patients underwent CE-MRC and T2W-MRC imaging. In the CE-MRC studies, hepatobiliary phase images were acquired 20 minutes after contrast injection. Two radiologists first evaluated the T2W-MRC and CE-MRC images separately in random order, and then they reviewed both images together 8 weeks later. The readers graded the quality of visualization of each biliary duct and the entire biliary tree (overall rating) using a five-point scale. Images with a grade of 3 or 4 were considered to provide sufficient visualization for clinical application, and those with a grade of 2 or less were considered to provide insufficient visualization. Laboratory data, Child-Pugh classification, and model for end-stage liver disease score were also recorded. RESULTS: The overall rating of T2W-MRC was significantly higher than that of CE-MRC (p < 0.001), although combined T2W/CE-MRC provided better visualization of biliary segments than T2W-MRC alone (p = 0.025). There were no significant differences between liver function and the overall rating of CE-MRC. CONCLUSION: CE-MRC is not superior to conventional T2W-MRC with respect to biliary visualization in patients with liver cirrhosis. However, a combination of T2W-MRC and CE-MRC provides significantly better visualization of biliary structures than T2W-MRC alone.
BACKGROUND:Gadoxetic acid is one of the hepatobiliary-specific agents and so can be used for contrast-enhanced magnetic resonance cholangiography (CE-MRC). The aim of our study was to compare the performance of CE-MRC with that of T2-weighted magnetic resonance cholangiography (T2W-MRC), and also to ascertain the effectiveness of both modalities combined for visualizing anatomic structures of the biliary tree in patients with liver cirrhosis. METHODS: Fifty-six patients underwent CE-MRC and T2W-MRC imaging. In the CE-MRC studies, hepatobiliary phase images were acquired 20 minutes after contrast injection. Two radiologists first evaluated the T2W-MRC and CE-MRC images separately in random order, and then they reviewed both images together 8 weeks later. The readers graded the quality of visualization of each biliary duct and the entire biliary tree (overall rating) using a five-point scale. Images with a grade of 3 or 4 were considered to provide sufficient visualization for clinical application, and those with a grade of 2 or less were considered to provide insufficient visualization. Laboratory data, Child-Pugh classification, and model for end-stage liver disease score were also recorded. RESULTS: The overall rating of T2W-MRC was significantly higher than that of CE-MRC (p < 0.001), although combined T2W/CE-MRC provided better visualization of biliary segments than T2W-MRC alone (p = 0.025). There were no significant differences between liver function and the overall rating of CE-MRC. CONCLUSION: CE-MRC is not superior to conventional T2W-MRC with respect to biliary visualization in patients with liver cirrhosis. However, a combination of T2W-MRC and CE-MRC provides significantly better visualization of biliary structures than T2W-MRC alone.
Authors: Ute Lina Fahlenkamp; Lisa Christine Adams; Sarah Maria Böker; Günther Engel; Minh Huynh Anh; Moritz Wagner; Bernd Hamm; Marcus Richard Makowski Journal: PLoS One Date: 2018-09-05 Impact factor: 3.240