Adult Bile Duct Strictures: Role of MR Imaging and MR Cholangiopancreatography in Characterization

Abstract

Bile duct strictures in adults are secondary to a wide spectrum of benign and malignant pathologic conditions. Benign causes of bile duct strictures include iatrogenic causes, acute or chronic pancreatitis, choledocholithiasis, primary sclerosing cholangitis, IgG4-related sclerosing cholangitis, liver transplantation, recurrent pyogenic cholangitis, Mirizzi syndrome, acquired immunodeficiency syndrome cholangiopathy, and sphincter of Oddi dysfunction. Malignant causes include cholangiocarcinoma, pancreatic adenocarcinoma, and periampullary carcinomas. Rare causes include biliary inflammatory pseudotumor, gallbladder carcinoma, hepatocellular carcinoma, metastases to bile ducts, and extrinsic bile duct compression secondary to periportal or peripancreatic lymphadenopathy. Contrast material-enhanced magnetic resonance (MR) imaging with MR cholangiopancreatography is extremely helpful in the noninvasive evaluation of patients with obstructive jaundice, an obstructive pattern of liver function, or incidentally detected biliary duct dilatation. Some of these conditions may show characteristic findings at MR imaging-MR cholangiopancreatography that help in making a definitive diagnosis. Although endoscopic retrograde cholangiopancreatography with tissue biopsy or surgery is needed for the definitive diagnosis of many of these strictures, certain MR imaging characteristics of the narrowed segment (eg, thickened wall, long-segment involvement, asymmetry, indistinct outer margin, luminal irregularity, hyperenhancement relative to the liver parenchyma) may favor a malignant cause. Awareness of the various causes of bile duct strictures in adults and familiarity with their appearances at MR imaging-MR cholangiopancreatography are important for accurate diagnosis and optimal patient management.

Role of MRCP in The Assessment of Patients Undergoing Cholecystectomy

“…In current study also, none of the cases (0%) had primary sclerosing cholangitis were detected. Katabathina et al (17) reported that, the incidence of primary sclerosing cholangitis in their study was (3.8 %). In the present study, the US couldn't detect anatomical variants in any case (0 %), while MRCP had detected anatomical variants in eight cases (26.7 %) out of thirty.…”

Duplicación de la vesícula biliar

“…También permite la visualización del árbol biliar y sus variaciones anatómicas. Sin embargo, se trata de un procedimiento invasivo, con morbilidad reportada hasta en un 7% de los casos 11 , por lo que se reserva para casos en donde se necesite realizar algún procedimiento terapéutico.…”

Causes and Treatment Tactics of “Fresh” Injuries of the Bile Ducts

“…Внедрение современного высокотехнологи-ческого медицинского оборудования в хирур-гическую практику позволило существенным образом улучшить качество диагностики и лечения заболеваний органов гепатогастробили-арной зоны [1,2]. Наряду с этим увеличивалось и количество интра-и послеоперационных ос-ложнений, среди которых наиболее трагичным для хирурга и пациента является повреждение желчных протоков (ПЖП) [2].…”

“…Наряду с этим увеличивалось и количество интра-и послеоперационных ос-ложнений, среди которых наиболее трагичным для хирурга и пациента является повреждение желчных протоков (ПЖП) [2]. При открытой холецистэктомии случайные ятрогенные ПЖП составляют 0,1-1% [3], при лапароскопических операциях -0,4-3,5% и даже 7% [4].…”