3D-TSE MR-cholangiography with respiratory triggering in the diagnosis of hepatopathies in infants and young children.

Purpose: Evaluation of 3D-TSE MR-cholangiography with respiratory triggerin g in the work up of hepatopathies in infants and young children. Patients a nd Method: 16 infants (4-16 years) with increased transaminases, two with r ecurrent pancreatitis, were examined at 1.5T(ACS-NT II, Philips Medical Sys tems) using a 3D-TSE MRCP with respiratory triggering in addition to a regu lar MRI of the liver. The MRCP was compared to ERCP. Two radiologists and o ne gastroenterologist evaluated the technical quality, visualization of the pancreaticobiliary system, and the diagnostic value of the examinations. R esults: Technically feasible were 14/16 MRCPs and 13/16 ERCPs. Two MRCP wer e not of diagnostic value due to motion artifacts and in three ERCP cannula tion of the papilla was not possible. 14/16 ERCP required general anaesthes ia, while MRCP needed i.v. sedation in two patients only. Extrahepatic duct s/cystic duct/pancreatic duct were visualized in 14/12/8 patients using MRC P, and in 13/10/3 patients using ERCP, both without adverse effects or comp lications. Intrahepatic ducts were better delineated with MRCP. In 10 patie nts with histologically proven periportal fibrosis (n = 7) and liver fibros is (n = 1) or antineutrophil cytoplasmatic antibodies and associated inflam matory bowel disease, MRCP and ERCP revealed pathological results. Conclusi on: MRCP using a 3D-TSE sequence with respiratory triggering is a good non- inivasive technique for delineation of the biliary tract in infants and you ng children for the work up to hepatopathies.