The Diagnostic Utility of HASTE MRI in the Evaluation of Acute Cholecystitis

Regan, Fintan; Schaefer, Dirk; Smith, David P.; Petronis, John D.; Bohlman, Mark E.; Magnuson, Tom H.

doi:10.1097/00004728-199807000-00025

Cited by 55 publications

(27 citation statements)

References 19 publications

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“…In this study, fMRC diagnosed all cases of acute cholecystitis with significantly greater confidence than conventional MRC. Regarding MRC findings, results concur with reports in the literature that describe pericholecystic fluid in only 24 -53% and gallstones in 53-90% of cases of acute cholecystitis (23)(24)(25). Hence, when using conventional MRC imaging alone, cholescintigraphy is often required for confirmation of acute cholecystitis, while imaging with fMRC may be sufficient.…”

Section: Discussionsupporting

confidence: 86%

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Fayad

Holland

Bergin

et al. 2003

Magnetic Resonance Imaging

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Purpose:To determine the diagnostic performance of functional magnetic resonance cholangiography (fMRC) for the evaluation of anatomic and functional biliary disorders.Materials and Methods: At 1.5 T, 39 MR examinations with conventional MRC and mangafodipir trisodium-enhanced fMRC were retrospectively reviewed by three observers who recorded anatomic (duct dilation, stricture, filling defects) and functional (cholecystitis, obstruction) abnormalities in three modes: MRC alone, fMRC alone, and MRC and fMRC images together (combined-MRC). Performance was determined by comparing findings with each mode to findings of invasive cholangiography (IC) and surgery.Results: Among 75 biliary segments (correlated with IC), the sensitivity/specificity for diagnosing dilation (N ϭ 41) with MRC was 95%/97%; with fMRC, 90%/100%; with combined-MRC, 100%/97%. For stricture (N ϭ 7), the sensitivity/specificity of MRC was 86%/98%; of fMRC, 43%/100%; of combined-MRC, 86%/100%. For filling defects (N ϭ 9), the sensitivity/specificity of MRC was 91%/98%; of fMRC, 82%/ 100%; of combined-MRC, 91%/100%. For diagnosing obstruction (N ϭ 9), the sensitivity/specificity of MRC, fMRC, and combined-MRC were 89%/100%, 100%/100%, and 100%/100%, respectively. For surgically proven cholecystitis (N ϭ 13), positive predictive values for diagnosing acute/ chronic cholecystitis for MRC were 33%/40%; for fMRC, 100%/50%; for combined-MRC, 100%/50%. Conclusion:Although single-shot fast spin echo (SSFSE)-MRC is valuable, the addition of fMRC increased diagnostic performance for functional biliary disorders.

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Section: Discussionsupporting

confidence: 86%

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Fayad

Holland

Bergin

et al. 2003

Magnetic Resonance Imaging

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“…They mentioned that gallbladder wall thickening in acute cholecystitis showed intermediate signal intensity on HASTE image. Regan et al [15] described that HASTE imaging has a high degree of accuracy in diagnosing acute cholecystitis based on the single finding of pericholecystic high signal intensity. However, to our knowledge, the differentiation of the gallbladder wall thickening focusing on the layered pattern using HASTE images has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

“…Although MR findings of acute cholecystitis, chronic cholecystitis and gallbladder carcinoma have been reported [5,6,[13][14][15][16][17], to our knowledge, MR imaging findings in large series of patients with gallbladder disease and the schematic analysis of MR imaging findings for gallbladder wall thickening have not been well documented. Therefore, the purpose of this study was to correlate the MR findings of gallbladder wall thickening with the pathologic findings on the basis of the layered pattern and to evaluate the diagnostic value of HASTE MR imaging in gallbladder disease.…”

Section: Figmentioning

confidence: 99%

Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

Jung

Lee

et al. 2004

Eur Radiol

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The aim of this study was to correlate MR findings of gallbladder wall thickening with pathologic findings on the basis of the layered pattern and to evaluate the diagnostic value of MR imaging in gallbladder disease. We retrospectively evaluated the source images of HASTE sequences for MR cholangiography in 144 patients with gallbladder wall thickening. The layered pattern of thickened wall was classified into four patterns. Type 1 shows two layers with a thin hypointense inner layer and thick hyperintense outer layer. Type 2 has two layers of ill-defined margin. Type 3 shows multiple hyperintense cystic spaces in the wall. Type 4 shows diffuse nodular thickening without layering. MR findings of a layered pattern of thickened gallbladder were well correlated with histopathology. Chronic cholecystitis matched to type 1, acute cholecystitis corresponded to type 2, adenomyomatosis showed type 3, and the gallbladder carcinomas showed type 4. All four layered patterns were associated with PPV of 73% or greater, sensitivity of 92% or greater and specificity of 95% or greater. Our results indicate that MR findings of gallbladder wall thickening are characteristic in each entity and correlate well with pathologic findings. The classification of the layered pattern may be valuable for interpreting thickened gallbladder wall.

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“…Suggestive clinical findings, a distended gallbladder in the presence of a cystic duct or a gallbladder neck calculus, and the presence of pericholecystic fluid are important, but not omnipresent findings of acute cholecystitis (14,15). On HASTE images, the wall thickening in acute cholecystitis is typified by an ill-defined double-layered pattern; a broadened or interrupted hypointense inner layer (composed of mucosa and muscle) is surrounded by a thick hyperintense outer layer (composed of edematous stroma and serosa) ( Fig.…”

Section: Acute Cholecystitismentioning

confidence: 99%

MRI of gallbladder cancer

Tan

Lim²

2013

Diagn Interv Radiol

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Gallbladder cancer, the most common of biliary tract cancer, is often diagnosed at an advanced stage with ensuing poor survival rates. Imaging may allow for earlier diagnosis, however there may be significant overlap with nonmalignant conditions of the gallbladder in early stages of cancer. In this pictorial essay, we use various examples to describe the utility of magnetic resonance imaging in the diagnosis and staging of gallbladder cancer, noting in particular the strengths and limitations of the imaging modality. The use of diffusionweighted imaging as an adjunct technique for diagnosis is also discussed.

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The Diagnostic Utility of HASTE MRI in the Evaluation of Acute Cholecystitis

Cited by 55 publications

References 19 publications

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast‐enhanced magnetic resonance cholangiography

Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern

MRI of gallbladder cancer

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