Keywords:
Radiographers, Biliary Tract / Gallbladder, MR, MR-Cholangiography, Contrast agent-oral, Contrast agent-intravenous, Cholangiography, Obstruction / Occlusion
Authors:
B. Zólyomi, I. Kéki; Budapest/HU
DOI:
10.26044/ecr2019/C-2209
Methods and materials
In the beginning of every examination,
patients had to drink T2 signal intensity decreasing fluid.
In order to reach the best efficiency,
we have tested several fluids.
The most suitable was the LumiVision® which is a purpose manufactured preparation of concentrates such as pineapple concentrate,
organic agave syrup and blackcurrant concentrate,
because of its high iron and manganese content.
We have applied 300 ml of this,
diluted with the same amount of water.
Patients had to drink it immediately before their examination,
on the examination table.
Fig. 2: Different fluids’ intensity on T2-weighted imaging. 1:1 diluted LumiVision® had the best fluid suppression attribution on T2-weighted imaging
We planned measures of the biliary system on the native liver images.
At first,
bile ducts were represented with a radially planned,
thick sliced,
heavily T2-weighted 2D sequence.
Fig. 4: Parameters of heavily T2-weighted 2D sequence
In certain cases when the preliminary diagnosis or the liver examination justified it,
we have also made thin sliced,
heavily T2-weighted 3D measurements.
Fig. 7: The parameters of heavily T2-weighted 3D sequence
Another method is the liver examination with hepato-specific contrast agent.
As this contrast agent is excreted by hepatocytes into the bile ducts,
we have made thin sliced fat suppressed T1-weighted images in a late biliary phase,
which were imaged with MIP technique.
In this case T2 signal intensity decreasing fluids were not necessary,
because of their inverse attribution; fluids in the stomach and duodenum were hyperintense on T1-weighted sequence.
Fig. 10: Parameters of T1-weighted sequence in biliary phase
Fig. 13: The intensity of T2 signal intensity decreasing fluids had inverse, high intensity on T1-weighted sequence