MRI for Evaluating Congenital Bile Duct Abnormalities

Abstract

Congenital bile duct diseases consist of ductal plate development abnormalities and are genetically determined. These biliary abnormalities are encountered mainly in congenital fibrocystic diseases, represented by congenital hepatic fibrosis and different forms of Caroli disease. On the other hand, polycystic hepatic diseases also present cystic abnormalities, which could be confused with biliary dilatations, especially in the perihilar area. Further, intricate forms between Caroli and polycystic hepatic diseases are possible. In congenital bile duct paucity, which is extremely rare, the biliary tree, located on the opposite, is not visible. MRI modalities for the analysis of the biliary tree are mainly represented by T -weighted sequence, also known as MR cholangiography (MRCP), and T gadolinium-enhanced sequences. Familiarity with the most common appearances of congenital bile duct dilations, its variants, and related complex diseases facilitates accurate diagnosis and allows and helps avoid misinterpretation.

Current management of noninfectious hepatic cystic lesions: A review of the literature

“…The gold standard for diagnosis is direct visualization of the biliary tree, either endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous trans-hepatic cholangiography (PTC) [66] . Magnetic resonance cholangiopancreatography (MRCP) is an emerging modality for diagnosis of Caroli's disease [67][68][69] . It has several advantages: noninvasive, readily available, and ability to visualize the entire biliary tract [70] .…”

Controversies in Choledochal Malformations: A Survey among Dutch Pediatric Surgeons

“…14,24 MRCP is relatively poor at imaging tortuous ducts, stones or ducts smaller than 5 mm and visualizing possible abnormal pancreaticobiliary junction. 19,20,25 Most important, MRCP has no immediate therapeutic options for treatment of a biliary problem. To our surprise, half of the respondents did not consider the presence of an asymptomatic CM per se an indication for surgery.…”

Respiratory-triggered Three-dimensional T2-weighted MR Cholangiography after Injection of Gadoxetate Disodium: Is It Still Reliable?

“…However, previous reports have indicated that high concentrations of a hepatobiliary contrast agent in the biliary ductal system may lead to signal distortion on T2-weighted images due to T2* effects M agnetic resonance (MR) cholangiography is an established technique used to evaluate the intra-and extrahepatic biliary tracts. It has evolved into a reliable noninvasive alternative to diagnostic endoscopic retrograde cholangiography ( 1,2 ) and is used in the primary diagnosis and follow-up of diseases-such as biliary obstruction due to infl ammation, tumor, or stones-as well as in the evaluation of postsurgical conditions (3)(4)(5). Most MR cholangiographic techniques are based on heavily T2-weighted fast spin-echo pulse sequences.…”