Learning objectives
The aim of this educational exhibit is to describe main imaging features of biliary disease in paediatric patients; in addition,
technical tricks and expedients for MRCP protocol are discussed,
to help radiologists in the management of these diseases.
Background
Pediatric patients may be affected by congenital and acquired biliary disease.
The diagnosis should be obtained through US and MRI findings,
in order to avoid ionizing radiation exposure.
MRCP is based on heavy T2-weighted sequences that have high diagnostic capability in showing and emphasizing the biliary tree and pancreatic duct.
However,
in infants or children MRCP represents a diagnostic challenge for radiologists,
with several tips and tricks required to optimize acquisition and protocol.
First of all,
different phased-array coils should be used according to the...
Findings and procedure details
Biliary diseases in pediatric patients have been summarized as proposed in Table 2
Congenital biliary diseases include biliary atresia,
cystic biliary lesions,
agenesia/malformation of gallbladder.
Acquired biliary diseases include lithiasis,
infections and Primary Sclerosing Cholangitis.
Biliary Atresia
Biliary atresia is the most common cause of persisting neonatal jaundice which affects 1 person in every 8,000,
occurring,
in particular,
in Asian populations.
The disease – in its typical evolution – is characterized by cholestatis and development of cirrhosis and hepatic fibrosis as a result of the...
Conclusion
The knowledge of main imaging features encountered in paediatric biliary disease is essential to provide a correct diagnosis.
Radiologists should know all the possible expedients to optimize MRCP acquisition,
particularly when pre-surgical assessment is required.
References
References
1) Darge K,
et al.
(2011) MR Imaging of the Abdomen and Pelvis in Infants,
Children,
and Adolescents.
Radiology
2) Mark E,
et al.
(2016) Pediatric cholangiopathies: diseases of the gallbladder and biliary tract.
Abdominal Radiology
3) Baumann U,
et al.
(2012) Biliary atresia.
Clin Res Hepatology Gastroenterology
4) Dolgin SE,
et al.
(2004) Answered and unanswered controversies in the surgical management of extra hepatic biliary atresia.
Pediatric Transplant
5) Kendrick APT,
et al.
(2000) Making the diagnosis of biliary atresia using the triangular...