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  • Title: Mangafodipir-enhanced magnetic resonance cholangiography for the diagnosis of bile duct leaks.
    Author: Pilleul F, Billaud Y, Gautier G, Monneuse O, Crombé-Ternamian A, Fouque P, Valette PJ.
    Journal: Gastrointest Endosc; 2004 Jun; 59(7):818-22. PubMed ID: 15173794.
    Abstract:
    BACKGROUND: The purpose of this prospective study was to assess the value of contrast-enhanced magnetic resonance cholangiography with mangafodipir trisodium perfusion for detection and localization of trauma-induced and postoperative bile duct leaks. METHODS: Eleven patients with suspected bile duct leaks after trauma (n=5) or surgery (n=6) were included. Patients with suspected leaks after cholecystectomy were excluded. All patients underwent contrast-enhanced magnetic resonance cholangiography with two-dimensional axial and three-dimensional coronal gradient-echo images acquired 1 to 3 hours after intravenous administration of mangafodipir trisodium perfusion. Contrast-enhanced magnetic resonance cholangiography findings were correlated with direct cholangiography obtained in all patients, including endoscopic retrograde (n=7) and percutaneous transhepatic cholangiography (n=4). RESULTS: Biliary tract enhancement was identified in all patients on contrast-enhanced magnetic resonance cholangiography. Peritoneal cavity fluid and bile collections that contained extravasated mangafodipir trisodium (increased signal intensity on gradient-echo sequences) were demonstrated in 6 patients. Direct cholangiography confirmed the presence of bile duct leaks in these 6 patients and the absence of bile duct leaks in 5 patients. There was no false-negative or false-positive contrast-enhanced magnetic resonance cholangiography. CONCLUSIONS: Mangafodipir-enhanced magnetic resonance cholangiography is a noninvasive technique that can provide functional biliary information with excellent depiction of bile duct leaks.
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