Magnetic resonance cholangiopancreatography (MRCP) using new negative per-oral contrast agent based on superparamagnetic iron oxide nanoparticles for extrahepatic biliary duct visualization in liver cirrhosis

Abstract

Background and Aims. Magnetic resonance cholangiopancreatography (MRCP) is often used for imaging of the biliary tree and is required by surgeons before liver transplantation. Advanced liver cirrhosis and ascites in patients however present diagnostic problems for MRCP. The aim of this study was to find out if the use of our negative per-oral contrast agent containing superparamagnetic iron oxide nanoparticles (SPIO) in MRCP is helpful for imaging of hepatobiliary tree in patients with liver cirrhosis. Methods. Forty patients with liver cirrhosis were examined on a 1.5 T MR unit using standard MRCP protocol. Twenty patients (group A) underwent MRCP after administration of per-oral SPIO contrast agent 30 min before examination. In group B, twenty patients were examined without per-oral bowel preparation. Ascites was present in eleven patients from group A and in thirteen patients in group B. Four radiologists analyzed MR images for visibility and delineation of the biliary tree. χ 2 tests were used for comparison of the visibility of intrahepatic and extrahepatic biliary ducts in patients with and without ascites. Results. Better extrahepatic biliary duct visualization and visibility of extraluminal pathologies in patients with ascites was proved after administration of SPIO contrast agent. No statistically significant difference between group A and B was found for visualization of extrahepatic biliary ducts in patients without ascites. Delineation of intrahepatic biliary ducts was independent on bowel preparation. Conclusions. Application of our negative per-oral SPIO contrast agent before MRCP improves the visualization of extrahepatic biliary ducts in patients with ascites which is helpful during the liver surgery, mainly in liver transplantation.

Oral effervescent agent improving magnetic resonance cholangiopancreatography

“…Several negative oral contrast agents for MRCP that render the bowel signal dark on T2-weighted sequences are commercially available [i.e., ferumoxsil (GastroMARK; Mallinckrodt Inc., Raleigh, NC, USA), manganese chloride, barium sulfate, and ferric particles] ( 20 , 21 ). Previous studies using these agents also showed the correlative results with our study for the improvement of visibility of biliary ducts.…”

Multimodal molecular imaging evaluation for early diagnosis and prognosis of cholangiocarcinoma

“…In another study by Simone et al, a patient with CCA was successfully identified by blind evaluation using SPIO [ 54 ]. Polakova et al indicated that oral SPIO negative contrast agent administered before MRCP improved the display rate of the extrahepatic bile duct, especially for patients with ascites [ 55 ].…”

Η Επίδραση Της Εκπαίδευσης Στην Προσήλωση Ασθενών Με Κίρρωση Ήπατος Στις Θεραπευτικές Συστάσεις

“…(Mania et al, 2011;Arif-Tiwari et al, 2014;Yeom et al, 2015). (Mania et al, 2011;Polakova et al, 2016).…”