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Published online before print March 4, 2005, 10.1148/radiol.2343040028
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(Radiology 2005;235:250-258.)
© RSNA, 2005

Technical Developments

Biliary Atresia: Feasibility of Mangafodipir Trisodium–enhanced MR Cholangiography for Evaluation1

Hun Kyu Ryeom, MD, Byung Ho Choe, MD, Jong Yeol Kim, MD, Soonhak Kwon, MD, Cheol Woo Ko, MD, Heng Mi Kim, MD, Sang Bum Lee, MD and Duk Sik Kang, MD

1 From the Departments of Radiology (H.K.R., J.Y.K., D.S.K.) and Pediatrics (B.H.C., S.K., C.W.K., H.M.K., S.B.L.), Kyungpook National University School of Medicine, Samduk 2Ga, Jung-Gu, Daegu 700–721, Republic of Korea. Received January 10, 2004; revision requested March 12; revision received May 14; accepted June 15. Supported by a BioMedical Research Institute grant, Kyungpook National University Hospital (2002). Address correspondence to B.H.C. (e-mail: bhchoi@knu.ac.kr).

The study was approved by the institutional review board, and informed consent was obtained from the patients’ parents. Twenty-three consecutive infants suspected of having biliary atresia (BA) were prospectively examined by using mangafodipir trisodium (Mn-DPDP)–enhanced magnetic resonance (MR) cholangiography. Sequential T1-weighted spoiled gradient-echo MR cholangiograms were obtained 1, 2, and 3 hours after intravenous administration of Mn-DPDP. The possibility of BA was excluded if bowel excretion of contrast material was noted at contrast material–enhanced MR cholangiography. The diagnostic specificity and accuracy of contrast-enhanced MR cholangiography were compared with those of conventional MR cholangiography, technetium 99m Tc (99mTc)–disofenin (DISIDA) scintigraphy, and the triangular cord sign at ultrasonography (US). MR cholangiography was used to accurately distinguish four cases of BA from 19 cases of other cholestatic liver diseases, without false-positive results. Conventional MR cholangiography, 99mTc-DISIDA scintigraphy, and the triangular cord sign at US respectively yielded false-positive results of 42% (eight of 19 infants), 35% (six of 17 infants), and 11% (two of 19 infants) in patients without BA. Mn-DPDP–enhanced MR cholangiography appears to be a promising modality for early diagnosis of BA as the cause of neonatal cholestasis.

© RSNA, 2005




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