When conventional techniques are not enough; Use of Gd-EOB-DTPA enhanced MRI in the evaluation of biliary tract pathology and liver function.

Congress:

ECR 2019

Poster Number:

C-3046

Type:

Educational Exhibit

Keywords:

Contrast agent-intravenous, Complications, Cholangiography, MR-Cholangiography, MR, Biliary Tract / Gallbladder, Anatomy, Abdomen, Dilatation

Authors:

M. Berlioz Ortiz¹, R. Rueda Castañón¹, F. Damián Salamanca², M. J. FERNÁNDEZ BERMÚDEZ¹, M. Valle Franco², L. Martínez González², I. M. LÓPEZ GARCÍA², F. J. Somalo ¹; ¹leon/ES, ²León/ES

DOI:

10.26044/ecr2019/C-3046

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3046

Fig. 1: Classical Biliary tree anatomy. Reference: Anatomy of the Pancreas and Biliary...

Fig. 2: Coronal MIP T2 haste that shows the dilated intrahepatic ducts and the common...

Fig. 3: Coronal T1 vibe fat supressed MRI images obtained after 90 minutes after...

Learning objectives

·To review Primovist’s physiological mechanism and characteristics. ·To illustrate the application of Primovist in evaluating pathology and the anatomy of the biliary tract , providing examples with clinical cases.

Background

Magnetic resonance imaging (MRI) has an important role in the detection and characterization of focal, diffuse liver diseases and biliary tract pathology. Contrast agents improve the detection of focal liver lesions by increasing the lesion-to-liver contrast. Some contrast agents have special properties for example that they are excreted in the biliary tract and thus provide useful anatomic and functional evaluation of the biliary tree. Gd-EOB-DTPA (Primovist) is one of the hepatocyte specific contrast agents designed to evaluate liver lesions in MRI. After intravenous administration, Gd-EOB-DTPA...

Findings and procedure details

T2- weighted MR cholangiography is a well-known method of studying the biliary system, but there are cases in which there is a need for a functional and detailed anatomy study that is not possible with conventional techniques. In this case T2- weighted MR cholangiography (MRC) in conjunction with EG-3D T1 Fatsat Gd-EOB-DTPA enhanced MRI can provide the required information. Contrast enhanced cholangiography MRI is also useful in the evaluation of different types of biliary tract pathology like assessment of bile duct obstruction, detection of bile...

Conclusion

The clinical applications of contrast enhanced MRC in the evaluation of the biliary system has not been fully explored. Our early experience with Gd-EOB-DTPA in different clinical settings has allowed us to understand that this technique is a valuable tool to evaluate the biliary system when there is a need for a detailed anatomical and functional overview of the biliary tract.

Personal information

References

Beers, B. E. Van, Pastor, C. M., & Hussain, H. K. (2012). Review Primovist, Eovist : What to expect ? Journal of Hepatology, 57(2), 421–429. https://doi.org/10.1016/j.jhep.2012.01.031 Norén, B., Dahlström, N., Fredrik, M., Dahlqvist, O., Kechagias, S., Almer, S., … Lundberg, P. (2015). Visual assessment of biliary excretion of Gd-EOB-DTPA in patients with suspected diffuse liver disease – A biopsy-verified prospective study. European Journal of Radiology Open, 2, 19–25. https://doi.org/10.1016/j.ejro.2014.12.004 Tschirch, F. T. C., & Petrowsky, H. (2008). Contrast-enhanced MR cholangiography with Gd-EOB-DTPA in patients with...