Biliary MR Imaging with Gd-EOB-DTPA and Its Clinical Applications

Abstract

The hepatocyte-specific contrast agent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) was developed to improve the detection and characterization of focal liver lesions at magnetic resonance (MR) imaging. Approximately 50% of the injected dose is taken up into the functional hepatocyte and is excreted via the biliary system. Because of this property, Gd-EOB-DTPA has the potential to be a biliary contrast agent. When combined with T2-weighted MR cholangiography, Gd-EOB-DTPA-enhanced MR imaging can allow morphologic and functional assessment of the biliary system. Gd-EOB-DTPA-enhanced MR cholangiography could be effective in evaluation of biliary anatomy, differentiation of biliary from extrabiliary lesions, diagnosis of cholecystitis, assessment of bile duct obstruction, detection of bile duct injury including leakage and stricture, evaluation of biliary-enteric anastomoses, postprocedure evaluation, differentiation of biloma from other pathologic conditions, and evaluation of sphincter of Oddi dysfunction. However, the clinical applications of this imaging technique have not yet been fully explored, and further investigations are needed to determine the utility of Gd-EOB-DTPA-enhanced MR cholangiography in a clinical setting.

Diagnosing the duct of Luschka injury at magnetic resonance imaging with hepatospecific contrast agents after laparoscopic cholecystectomy

“…Ancak safra kaçaği azsa birkaç gün içinde kendiliğinden durur [12]. Major safra yollarinda belirgin yaralanmanin olmadiği safra kaçaği tedavisinde ERCP ile sfinkterotomi, safra yollarina endoskopik stent ve bilioma varliğinda perkütan drenaj kateteri takilabilir [2,3,8,13]. Bizim olgumuzda operasyonda safra kesesi lojuna yerleştirilen drenaj kateterinden saptanan safra kaçaği hasta takibinde azalarak kendiliğinden durmuştur.…”

“…Ama bu koleksiyonun safra kaçaği, hematom, seröz sivi veya apse ayrimi hakkinda net bilgi edinilemez [14]. Kesitsel radyolojik incelemelerde safra kesesi yatağinda ve perihepatik alanda sivi görülse de bu sivinin safra yollari ile bağlantisi olup olmadiği gösterilemez [2]. Perkütan transhepatik kolanjiografi ve ERCP işlemleriyle olasi kaçak alani gösterilebilir ve dekompresyon için stent takmak da mümkündür ancak bu incelemeler invaziv tekniklerdir.…”

“…Safra yolu yaralanmalari cerrahide özellikle laparoskopik kolesistektomide (LK) en sik ve en ciddi komplikasyondur. Açik kolesistektomide safra yolu yaralanma sikliği %0.1-0.3 iken LK' de %0.4-0.8 araliğindadir [2,3]. Safra kaçaği sistik kanal güdüğünden, aksesuar safra kanalindan veya karaciğerin safra kesesi yatağindaki Luschka kanalindan kaynaklanabilir [4].…”

“…Gd-EOB-BOPTA ile safra yollarindaki anatomik varyasyonlar görülebilir. Cerrahi öncesinde bu varyasyonlara bağli olasi safra yolu yaralanmalari engellenebilir ve cerrahi sonrasinda oluşan yaralanmalarin lokalizasyonlari aktif safra kaçaği gösterilerek saptanabilir [2].…”

Noninvasive Preclinical and Clinical Imaging of Liver Transporter Function Relevant to Drug-Induced Liver Injury

“…Therefore it allows differentiation between two subgroups of nonalcoholic fatty liver disease, plus between simple steatosis and nonalcoholic steatohepatitis [114]; and also can be used for assessment and staging of fibrosis [76] and cirrhosis [115], as well as in predicting liver transplant graft survival [116]. In addition, gadoxetate enhanced MR imaging together with T2-weighted MR cholangiography may be a useful tool in providing information about the biliary system, like biliary injury, bile duct obstruction, diagnosis of cholecystitis, and differentiation of biliary from extrabiliary lesions [117,118].…”