Abstract:Brazil. Cholangiographic images were analyzed and results were compared with intraoperative findings. Only anatomical alterations that affected the surgical strategy and had not been previously observed at magnetic resonance cholangiography were considered as being in disagreement. RESULTS: Anatomical variations were found in 7 donors at magnetic resonance cholangiography, and in 14 during surgery. Agreement between imaging and surgical findings was observed in 41 of the 50 patients, and disagreement in 9. Mag… Show more
“…In the evaluation of conditions affecting the pancreatic and biliary tract, MRCP has been playing an increasing role on account of its many advantages and complementarity with ultrasonography (28)(29)(30) . Establishing a MRCP exam protocol that makes it simpler, faster and more efficient without impairing its diagnostic capability is important, and the present study is aimed at contributing in such sense.…”
Objective: To assess the impact of oral ranitidine on the imaging quality in magnetic resonance cholangiopancreatography (MRCP). Materials and Methods: Thirty-two patients underwent MRCP with 3D and 2D acquisitions, and three strategies for suppression of the gastrointestinal fluid signal: a) only at fasting; b) 12 hours after ingestion of 300 mg ranitidine; c) after oral administration of gadolinium solution. Three observers reviewed the images with a focus on the degree of visualization of the biliopancreatic tree. The interobserver agreement was evaluated with the kappa test. The difference between techniques and acquisition modalities were evaluated by means of average grading scores. Results: The three strategies for suppression of the gastrointestinal fluid signal presented high reproducibility. The results with suppression of the gastrointestinal fluid signal with ranitidine where similar to those obtained with fasting, and both were worse than those obtained with gadolinium solution. The 3D acquisitions surpassed 2D only in terms of visibility of the cystic duct and gallbladder, and were inferior or equivalent in the other biliopancreatic ductal segments. Conclusion: The use of ranitidine does not seem justified in the evaluation of the biliopancreatic tree at MRCP, since 2D MRCP with fasting allows the visualization of ductal structures with high quality and reproducibility in the majority of cases. Keywords: Ranitidine; Diagnostic use; Magnetic resonance cholangiopancreatography; Contrast media; Bile ducts; Pancreatic ducts.Objetivo: Avaliar o impacto da ranitidina por via oral na qualidade do exame de colangiopancreatografia por ressonân-cia magnética (CPRM). Materiais e Métodos: Trinta e dois pacientes realizaram CPRM com aquisições 3D e 2D, com três estratégias de supressão do sinal líquido gastrintestinal: a) apenas em jejum; b) 12 horas após ingerir 300 mg de ranitidina; c) após a ingestão de solução de gadolínio. Três observadores avaliaram os estudos, atentos para o grau de visualização da árvore biliopancreática. Foi medida a concordância interobservador com o teste kappa. A diferença entre técnicas e formas de aquisição foi avaliada pela média da soma dos escores de graduação. Resultados: As três estratégias de supressão do sinal líquido gastrintestinal apresentaram elevada reprodutibilidade. A supressão do sinal líquido gastrintestinal com a ranitidina foi semelhante ao jejum e ambas foram piores do que a solução de gadolínio. As aquisições 3D superaram a 2D apenas na visualização do ducto cístico e da vesícula biliar, sendo inferior ou equivalente nos demais segmentos ductais biliopancreáticos. Conclusão: O uso da ranitidina não parece justificado para aprimorar a avaliação da árvore biliopancreática em exames de CPRM. A CPRM 2D apenas em jejum permite a visualização ductal com elevada qualidade e reprodutibilidade na maioria dos casos. Unitermos: Ranitidina; Uso diagnóstico; Colangiopancreatografia por ressonância magnética; Meios de contraste; Ductos biliares; Ductos pancreáticos.
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“…In the evaluation of conditions affecting the pancreatic and biliary tract, MRCP has been playing an increasing role on account of its many advantages and complementarity with ultrasonography (28)(29)(30) . Establishing a MRCP exam protocol that makes it simpler, faster and more efficient without impairing its diagnostic capability is important, and the present study is aimed at contributing in such sense.…”
Objective: To assess the impact of oral ranitidine on the imaging quality in magnetic resonance cholangiopancreatography (MRCP). Materials and Methods: Thirty-two patients underwent MRCP with 3D and 2D acquisitions, and three strategies for suppression of the gastrointestinal fluid signal: a) only at fasting; b) 12 hours after ingestion of 300 mg ranitidine; c) after oral administration of gadolinium solution. Three observers reviewed the images with a focus on the degree of visualization of the biliopancreatic tree. The interobserver agreement was evaluated with the kappa test. The difference between techniques and acquisition modalities were evaluated by means of average grading scores. Results: The three strategies for suppression of the gastrointestinal fluid signal presented high reproducibility. The results with suppression of the gastrointestinal fluid signal with ranitidine where similar to those obtained with fasting, and both were worse than those obtained with gadolinium solution. The 3D acquisitions surpassed 2D only in terms of visibility of the cystic duct and gallbladder, and were inferior or equivalent in the other biliopancreatic ductal segments. Conclusion: The use of ranitidine does not seem justified in the evaluation of the biliopancreatic tree at MRCP, since 2D MRCP with fasting allows the visualization of ductal structures with high quality and reproducibility in the majority of cases. Keywords: Ranitidine; Diagnostic use; Magnetic resonance cholangiopancreatography; Contrast media; Bile ducts; Pancreatic ducts.Objetivo: Avaliar o impacto da ranitidina por via oral na qualidade do exame de colangiopancreatografia por ressonân-cia magnética (CPRM). Materiais e Métodos: Trinta e dois pacientes realizaram CPRM com aquisições 3D e 2D, com três estratégias de supressão do sinal líquido gastrintestinal: a) apenas em jejum; b) 12 horas após ingerir 300 mg de ranitidina; c) após a ingestão de solução de gadolínio. Três observadores avaliaram os estudos, atentos para o grau de visualização da árvore biliopancreática. Foi medida a concordância interobservador com o teste kappa. A diferença entre técnicas e formas de aquisição foi avaliada pela média da soma dos escores de graduação. Resultados: As três estratégias de supressão do sinal líquido gastrintestinal apresentaram elevada reprodutibilidade. A supressão do sinal líquido gastrintestinal com a ranitidina foi semelhante ao jejum e ambas foram piores do que a solução de gadolínio. As aquisições 3D superaram a 2D apenas na visualização do ducto cístico e da vesícula biliar, sendo inferior ou equivalente nos demais segmentos ductais biliopancreáticos. Conclusão: O uso da ranitidina não parece justificado para aprimorar a avaliação da árvore biliopancreática em exames de CPRM. A CPRM 2D apenas em jejum permite a visualização ductal com elevada qualidade e reprodutibilidade na maioria dos casos. Unitermos: Ranitidina; Uso diagnóstico; Colangiopancreatografia por ressonância magnética; Meios de contraste; Ductos biliares; Ductos pancreáticos.
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