MR CHOLANGIOGRAPHY IN THE EXAMINATION OF PATIENTS WITH BILIARY-ENTERIC ANASTOMOSES

OBJECTIVE. The aim of our study was to determine the role of MR cholan giography in the noninvasive examination of patients with biliary-ente ric anastomoses.SUBJECTS AND METHODS. Twenty-four patients (nine men a nd 15 women; mean age, 68.9 years old) with biliary-enteric anastomose s underwent MR cholangiography. We used a fat-suppressed three-dimensi onal turbo spin-echo sequence (3000/700 [TR/TE]; echo train length, 12 8) with no breath-hold, optimized with a 0.5-T magnet. Imaging studies were performed because of scheduled follow-up (five patients), persis tent jaundice (six patients), cholangitis and abnormal liver function (eight patients), and a combination of transient jaundice, epigastric pain, and abnormal liver function (five patients). RESULTS. Image qual ity was graded from optimal to good in 21 (88%) of 24 cases and poor i n three (13%) of 24 cases. The degree of bile duct dilatation was corr ectly assessed, with complete agreement between the two observers in a l] cases. MR cholangiography correctly showed bile duct irregularities in six of the eight patients with cholangitis (kappa = .59), anastomo tic strictures in all 19 patients with strictures (kappa = .86), and 3 - to 15-mm stones in nine of 10 patients (kappa = .95). A slight overe stimation of the strictures occurred in four of the 19 cases with stri ctures. CONCLUSION. MR cholangiography is a reliable imaging technique for the examination of patients with biliary-enteric anastomoses.