HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lopera, J. E. Articles by Múnera, F. Search for Related Content PubMed PubMed Citation Articles by Lopera, J. E. Articles by Múnera, F.

Malignant Hilar and Perihilar Biliary Obstruction: Use of MR Cholangiography to Define the Extent of Biliary Ductal Involvement and Plan Percutaneous Interventions¹

¹ From the Department of Radiology, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl, Medellín, Colombia. Received September 8, 2000; revision requested October 26; revision received January 3, 2001; accepted January 16. Address correspondence to J.E.L., Department of Radiology, Louisiana State University, 1542 Tulane Ave, New Orleans, LA 70112 (e-mail: jloper@lsuhsc.edu).

PURPOSE: To determine the usefulness of magnetic resonance (MR) cholangiography in defining the extent of biliary ductal involvement in patients with malignant hilar and perihilar biliary obstruction and to evaluate whether findings at MR cholangiography alone are sufficient to plan percutaneous interventions in these patients.

MATERIALS AND METHODS: Twenty-nine patients with malignant hilar and perihilar biliary obstruction were examined with MR cholangiography. Two radiologists evaluated MR images and determined the extent of biliary ductal involvement. A hypothetical plan for biliary drainage was established prior to any intervention. All patients underwent percutaneous cholangiography, and 27 of 29 patients also underwent biliary drainage and/or stent placement within 7 days after MR cholangiography. By using direct cholangiography as the standard of reference, the usefulness of MR cholangiography in defining the extent of biliary ductal involvement was determined. The type of drainage performed was compared with the type that had been anticipated at MR cholangiography.

RESULTS: MR cholangiography was adequate in helping predict the extent of biliary ductal involvement in 28 (96%) of 29 patients and led to underestimation of the extent of the disease in one patient. The therapeutic plan anticipated with MR cholangiography matched the one actually used in 24 (83%) of 29 patients.

CONCLUSION: The high accuracy of MR cholangiography for defining extent of ductal involvement in patients with malignant hilar and perihilar obstruction allows adequate planning of percutaneous interventions in a majority of patients.

Index terms: Bile duct radiography, 768.1226 • Bile ducts, interventional procedures, 768.1263, 768.1267 • Bile ducts, MR, 768.121411 • Bile ducts, neoplasms, 768.321, 768.323 • Bile ducts, stenosis or obstruction, 768.143 • Bile ducts, stents and prostheses, 768.1267

This article has been cited by other articles:

				H. S. Park, J. M. Lee, J.-Y. Choi, M. W. Lee, H. J. Kim, J. K. Han, and B. I. Choi Preoperative Evaluation of Bile Duct Cancer: MRI Combined with MR Cholangiopancreatography Versus MDCT with Direct Cholangiography Am. J. Roentgenol., February 1, 2008; 190(2): 396 - 405. [Abstract] [Full Text] [PDF]

				J. M. Slattery and D. V. Sahani What Is the Current State-of-the-Art Imaging for Detection and Staging of Cholangiocarcinoma? Oncologist, September 1, 2006; 11(8): 913 - 922. [Abstract] [Full Text] [PDF]

				H. Y. Lee, S. H. Kim, J. M. Lee, S.-W. Kim, J.-Y. Jang, J. K. Han, and B. I. Choi Preoperative Assessment of Resectability of Hepatic Hilar Cholangiocarcinoma: Combined CT and Cholangiography with Revised Criteria Radiology, April 1, 2006; 239(1): 113 - 121. [Abstract] [Full Text] [PDF]

				H. J. Kim, A. Y. Kim, S. S. Hong, M.-H. Kim, J. H. Byun, H. J. Won, Y. M. Shin, P. N. Kim, H. K. Ha, and M.-G. Lee Biliary Ductal Evaluation of Hilar Cholangiocarcinoma: Three-dimensional Direct Multi-Detector Row CT Cholangiographic Findings versus Surgical and Pathologic Results--Feasibility Study Radiology, December 1, 2005; 238(1): 300 - 308. [Abstract] [Full Text] [PDF]

				J. Romagnuolo, M. Bardou, E. Rahme, L. Joseph, C. Reinhold, and A. N. Barkun Magnetic Resonance Cholangiopancreatography: A Meta-Analysis of Test Performance in Suspected Biliary Disease Ann Intern Med, October 7, 2003; 139(7): 547 - 557. [Abstract] [Full Text] [PDF]