Advantages of gadobenate dimeglumine-enhanced MR cholangiography in the diagnosis of post-liver transplant bile leakage

Diagn Interv Imaging. 2013 Apr;94(4):443-52. doi: 10.1016/j.diii.2013.01.004. Epub 2013 Feb 19.

Abstract

Objective: To assess the value of magnetic resonance cholangiography with gadobenate dimeglumine (Gd-BOPTA) where there is a suspicion of bile leakage in the post-liver transplant patient.

Patients and methods: Eight patients who had undergone a liver transplant underwent 14 MR cholangiograms, five of whom presented bile leakage while the other three had no biliary system complications. The results were compared to conventional bile duct opacification (by endoscopy or t-tube cholangiogram). The analysis covered whether there was opacification of the common bile duct and intrahepatic bile ducts on T1-weighted sequences after an injection of Gd-BOPTA on delayed biliary excretion phase sequences that were carried out on average 74 min after the injection. Enhancing perihepatic collections were also taken into account.

Results: Opacification of the bile ducts on delayed-phase MR cholangiogram sequences was always seen in the absence of bile leakage, and was never found when leakage was present. Enhancing perihepatic collections pointed to bile leakage every time.

Conclusion: Gd-BOPTA-enhanced MR cholangiography is a simple and non-invasive technique for detecting bile leakage in the post-liver transplant patient.

MeSH terms

  • Adult
  • Anastomotic Leak / diagnosis*
  • Bile Duct Diseases / diagnosis*
  • Bile*
  • Carcinoma, Hepatocellular / surgery
  • Cholangiography
  • Cholangiopancreatography, Magnetic Resonance*
  • Contrast Media / administration & dosage*
  • Female
  • Hepatitis C, Chronic / surgery
  • Humans
  • Image Enhancement*
  • Liver Cirrhosis, Alcoholic / surgery
  • Liver Neoplasms / surgery
  • Liver Transplantation*
  • Male
  • Meglumine / analogs & derivatives*
  • Middle Aged
  • Organometallic Compounds*
  • Postoperative Complications / diagnosis*

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine

Supplementary concepts

  • Fibrolamellar hepatocellular carcinoma