Katerina Polakova1, Ingrid Mocikova2,3, Dana Purova4, Pavel Tucek4, Pavel Novak2, Katerina Novotna3, Niko Izak3, Radoslav Bielik3, Radek Zboril1, Herman Miroslav5. 1. Regional Centre of Advanced Technologies and Materials, Departments of Physical Chemistry and Experimental Physics, Faculty of Science, Palacky University Olomouc, Czech Republic. 2. Medihope s.r.o., Mathonova 291/1, 796 04 Prostejov, Czech Republic. 3. Department of Radiology, F.D.Roosevelt Faculty Hospital, Banska Bystrica, Slovak Republic. 4. Department of Geoinformatics, Faculty of Science, Palacky University Olomouc, Czech Republic. 5. Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Abstract
BACKGROUND AND AIMS: Magnetic resonance cholangiopancreatography (MRCP) is often used for imaging of the biliary tree and is required by surgeons before liver transplantation. Advanced liver cirrhosis and ascites in patients however present diagnostic problems for MRCP. The aim of this study was to find out if the use of our negative per-oral contrast agent containing superparamagnetic iron oxide nanoparticles (SPIO) in MRCP is helpful for imaging of hepatobiliary tree in patients with liver cirrhosis. METHODS: Forty patients with liver cirrhosis were examined on a 1.5 T MR unit using standard MRCP protocol. Twenty patients (group A) underwent MRCP after administration of per-oral SPIO contrast agent 30 min before examination. In group B, twenty patients were examined without per-oral bowel preparation. Ascites was present in eleven patients from group A and in thirteen patients in group B. Four radiologists analyzed MR images for visibility and delineation of the biliary tree. χ2 tests were used for comparison of the visibility of intrahepatic and extrahepatic biliary ducts in patients with and without ascites. RESULTS: Better extrahepatic biliary duct visualization and visibility of extraluminal pathologies in patients with ascites was proved after administration of SPIO contrast agent. No statistically significant difference between group A and B was found for visualization of extrahepatic biliary ducts in patients without ascites. Delineation of intrahepatic biliary ducts was independent on bowel preparation. CONCLUSIONS: Application of our negative per-oral SPIO contrast agent before MRCP improves the visualization of extrahepatic biliary ducts in patients with ascites which is helpful during the liver surgery, mainly in liver transplantation.
BACKGROUND AND AIMS: Magnetic resonance cholangiopancreatography (MRCP) is often used for imaging of the biliary tree and is required by surgeons before liver transplantation. Advanced liver cirrhosis and ascites in patients however present diagnostic problems for MRCP. The aim of this study was to find out if the use of our negative per-oral contrast agent containing superparamagnetic iron oxide nanoparticles (SPIO) in MRCP is helpful for imaging of hepatobiliary tree in patients with liver cirrhosis. METHODS: Forty patients with liver cirrhosis were examined on a 1.5 T MR unit using standard MRCP protocol. Twenty patients (group A) underwent MRCP after administration of per-oral SPIO contrast agent 30 min before examination. In group B, twenty patients were examined without per-oral bowel preparation. Ascites was present in eleven patients from group A and in thirteen patients in group B. Four radiologists analyzed MR images for visibility and delineation of the biliary tree. χ2 tests were used for comparison of the visibility of intrahepatic and extrahepatic biliary ducts in patients with and without ascites. RESULTS: Better extrahepatic biliary duct visualization and visibility of extraluminal pathologies in patients with ascites was proved after administration of SPIO contrast agent. No statistically significant difference between group A and B was found for visualization of extrahepatic biliary ducts in patients without ascites. Delineation of intrahepatic biliary ducts was independent on bowel preparation. CONCLUSIONS: Application of our negative per-oral SPIO contrast agent before MRCP improves the visualization of extrahepatic biliary ducts in patients with ascites which is helpful during the liver surgery, mainly in liver transplantation.
Entities:
Keywords:
ascites; cirrhosis; liver transplantation; magnetic resonance cholangiopancreatography (MRCP); per-oral MR contrast agent; superparamagnetic iron oxide (SPIO) nanoparticles
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