MR cholangiography in children and young adults with biliary disease

OBJECTIVE. Our objective was to describe the MR cholangiography findings fo r young patients with suspected biliary disease who underwent half-Fourier acquisition fast spin-echo technique with respiratory triggering. SUBJECTS AND METHODS. Twenty-eight MR cholangiography studies were performe d in 22 patients on a 1.5-MR unit. Ten of these 22 patients had undergone l iver transplantation. RESULTS. MR cholangiography revealed abnormalities of both the extrahepatic and the intrahepatic major and minor bile duct systems, despite the small diameter of the duct system in this group of patients. Four patterns of bil iary disease were shown: global dilatation of extrahepatic or intrahepatic ducts (n = 7); segmental, uniform dilatation of central or peripheral intra hepatic ducts (n = 9); segmental, nonuniform dilatation of central or perip heral intrahepatic ducts (n = 2); and fusiform ectasia with segmental, irre gular intrahepatic dilatation and bile lakes (n = 2). The findings of eight studies were interpreted as normal. The four patterns of abnormalities wer e correlated with the results from percutaneous transhepatic cholangiograph y, T-tube cholangiography, and liver biopsy and with clinical and surgical information, as available. CONCLUSION. MR cholangiography is a noninvasive technique for evaluation of biliary disease. The improved resolution afforded by respiratory triggerin g permits evaluation of both major and minor bile ducts, even in young, unc ooperative subjects. Four patterns of abnormalities were prospectively iden tified, correlated with other information, and used to direct clinical trea tment.