Prospective assessment of dynamic CT and MR cholangiography in functional biliary pain
| Autor: | Mark Topazian, Jeff L. Fidler, Douglas A. Collins, Kiaran P. McGee, John M. Knudsen, Johnson L. Thistle, Brian D. Lahr |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Abdominal pain medicine.medical_specialty Adolescent Colic Cholangiopancreatography Magnetic Resonance Iodipamide Contrast Media Gallbladder Diseases Scintigraphy Sincalide Cholangiography Iodipamide Meglumine Imaging Three-Dimensional Meglumine Recurrence Image Interpretation Computer-Assisted medicine Organometallic Compounds Humans Radiology Nuclear Medicine and imaging Prospective Studies medicine.diagnostic_test Bile duct business.industry Phantoms Imaging Gallbladder General Medicine Middle Aged medicine.anatomical_structure Concordance correlation coefficient Case-Control Studies Positron-Emission Tomography Female Radiology medicine.symptom business Tomography X-Ray Computed medicine.drug |
| Zdroj: | AJR. American journal of roentgenology. 201(2) |
| ISSN: | 1546-3141 |
| Popis: | The objectives of our study were to assess the feasibility of dynamic CT and MR cholangiography during gallbladder stimulation, to compare CT and MR cholangiography with biliary scintigraphy, and to identify morphologic differences between patients with functional biliary pain and healthy control subjects.In this prospective study, 30 patients with functional biliary pain underwent biliary scintigraphy, CT cholangiography, and MR cholangiography before and during 45-minute sincalide infusions. Thirty healthy control subjects also underwent MR cholangiography with sincalide infusion. IV contrast agents (iodipamide meglumine or gadobenate dimeglumine) were administered before scanning. CT and MR images were qualitatively and quantitatively analyzed.Diagnostic images were obtained of all participants. There was good agreement for gallbladder ejection fraction (EF) at 40 minutes by all three methods (Lin's concordance correlation coefficient ≥ 0.6). Gallbladder contraction and refilling occurred more promptly by CT and MR cholangiography than scintigraphy. CT and MR cholangiography showed previously undiagnosed gallstones in two patients (7%). Gallbladder shape was categorized as straight, curved, or folded; a folded gallbladder was present in 37% and 23% of patients at baseline and 40 minutes, respectively, versus in 3% of control subjects at both times (p ≤ 0.004). Asymmetric patterns of gallbladder contraction occurred in 10 patients (33%) and four control subjects (13%) (p = 0.13).Dynamic CT cholangiography and MR cholangiography performed during pharmacologic stimulation accurately measure gallbladder EFs and detect missed gallstones. Gallbladder shape before and during contraction differs between patients with functional biliary pain and healthy control subjects. Dynamic CT cholangiography and MR cholangiography are promising techniques that might improve selection of patients to undergo cholecystectomy for functional biliary pain. |
| Databáze: | OpenAIRE |
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