Park Mi-Suk, Kim Ki Whang, Yu Jeong-Sik, Kim Myeong-Jin, Kim Kyoung Won, Lim Joon Suk, Cho Eun-Suk, Yoon Dong-Sup, Kim Tae Kyoung, Lee Sung In, Lee Jong Du, Lee Woo Jung, Ha Hyun Kwon, Lee Jong Tae, Yoo Hyung Sik
Department of Diagnostic Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
AJR Am J Roentgenol. 2004 Dec;183(6):1559-66. doi: 10.2214/ajr.183.6.01831559.
Our aim was to assess preliminary experience with combined conventional T2-weighted and mangafodipir trisodium (MnDPDP)-enhanced T1-weighted MR cholangiography in evaluating early biliary complications of laparoscopic cholecystectomy.
Conventional heavily T2-weighted MR cholangiography with MnDPDP-enhanced T1-weighted MR cholangiography and ERCP were performed in seven patients with high clinical suspicion of biliary complications after laparoscopic cholecystectomy. The final diagnoses of complications were classified according to the presence and degree of bile duct injury, bile leakage, and retained stones.
The diagnoses on MR cholangiography were as follows: complete transection and occlusion of the common bile duct with bile leakage (n = 3), partial strictures of the common bile duct with bile leakage (n = 1), cystic duct leakage (n = 1), partial ligation of an aberrant right hepatic duct (n = 1), and hemorrhage without biliary complication (n = 1). The final diagnoses at surgery (n = 2) and ERCP (n = 5) were as follows: complete transection and occlusion of the common bile duct with bile leakage (n = 2), partial strictures of the common bile duct with bile leakage (n = 2), cystic duct leakage (n = 1), partial ligation of an aberrant right hepatic duct (n = 1), and hemorrhage without biliary complication (n = 1). MR cholangiography accurately yielded the same findings as the final diagnoses, except in one case with partial stricture of the bile duct with bile leakage (overdiagnosed as complete occlusion on MR cholangiography).
Combined conventional T2-weighted and MnDPDP-enhanced T1-weighted MR cholangiography may eliminate the use of other studies for the imaging of biliary complications after cholecystectomy if this preliminary data can be verified in a larger study.
我们的目的是评估联合传统T2加权和锰福地匹三钠（MnDPDP）增强T1加权磁共振胰胆管造影术在评估腹腔镜胆囊切除术后早期胆道并发症方面的初步经验。
对7例临床高度怀疑腹腔镜胆囊切除术后发生胆道并发症的患者进行了传统的重T2加权磁共振胰胆管造影术、MnDPDP增强T1加权磁共振胰胆管造影术和内镜逆行胰胆管造影术（ERCP）。根据胆管损伤、胆漏和残留结石的存在情况及程度对并发症进行最终诊断分类。
磁共振胰胆管造影的诊断结果如下：胆总管完全横断并闭塞伴胆漏（n = 3）、胆总管部分狭窄伴胆漏（n = 1）、胆囊管漏（n = 1）、异常右肝管部分结扎（n = 1）、无胆道并发症的出血（n = 1）。手术（n = 2）和ERCP（n = 5）的最终诊断结果如下：胆总管完全横断并闭塞伴胆漏（n = 2）、胆总管部分狭窄伴胆漏（n = 2）、胆囊管漏（n = 1）、异常右肝管部分结扎（n = 1）、无胆道并发症的出血（n = 1）。磁共振胰胆管造影准确得出了与最终诊断相同的结果，但有1例胆总管部分狭窄伴胆漏的病例除外（磁共振胰胆管造影将其过度诊断为完全闭塞）。
如果这一初步数据能在更大规模的研究中得到验证，联合传统T2加权和MnDPDP增强T1加权磁共振胰胆管造影术可能无需使用其他检查来对胆囊切除术后的胆道并发症进行成像。
