Marin Daniele, Bova Valentina, Agnello Francesco, Youngblood Richard, Midiri Massimo, Brancatelli Giuseppe
Department of Radiology, Duke University Medical Center, Durham, NC, USA.
J Comput Assist Tomogr. 2010 Mar-Apr;34(2):213-6. doi: 10.1097/RCT.0b013e3181c1a72c.
We report a case of an endoscopically confirmed biliary leak of the common hepatic duct after laparoscopic cholecystectomy that was prospectively diagnosed on gadoxetate disodium-enhanced magnetic resonance cholangiography. Whereas dynamic contrast-enhanced magnetic resonance images during the early vascular phases helped to rule out the causes of possible complications such as seroma, hematoma, or abdominal abscess, delayed hepatobiliary phase imaging was crucial for unequivocal diagnosis and location of the biliary leak. The diagnosis prompted therapeutic endoscopic retrograde cholangiography whereby a polytetrafluoroethylene-covered nitinol stent graft was successfully placed to repair the biliary injury.
我们报告一例腹腔镜胆囊切除术后经内镜证实的肝总管胆漏病例，该病例通过钆塞酸二钠增强磁共振胆胰管造影术得以前瞻性诊断。早期血管期的动态对比增强磁共振图像有助于排除可能并发症的原因，如血清肿、血肿或腹腔脓肿，而延迟肝胆期成像对于明确胆漏的诊断和定位至关重要。该诊断促使进行治疗性内镜逆行胆胰管造影，通过该操作成功置入了一个聚四氟乙烯覆盖的镍钛合金支架移植物来修复胆管损伤。
