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Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0000000000000083
Abdominal Imaging

Detection and Localization of Bile Duct Leaks After Cholecystectomy Using Gd-EOB-DTPA—Enhanced MR Cholangiography: Retrospective Study of 16 Patients

Ratcliffe, Gregory E. MD*; Kirkpatrick, Iain D. MD; Anik Sahni, V. MD; Greenberg, Howard M. MD*; Henderson, Blair MD*; Radulovic, Dejana MD§; Mottola, Jeffrey C. MD*

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Abstract

Objective

To determine if gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) cholangiography can detect and localize bile duct leaks in postcholecystectomy patients.

Material and Methods

Four blinded independent radiologists performed a retrospective review of 16 consecutive patients who underwent MR cholangiography with intravenous Gd-EOB-DTPA for the evaluation of possible biliary leak. Image quality, ductal opacification, and presence and location of any bile leak were evaluated. An independent observer determined the criterion standard using a consensus of all chart, clinical, and imaging findings.

Results

All 6 bile leaks confirmed at endoscopic retrograde cholangiopancreatography were diagnosed by all reviewers (sensitivity, 100%). Of the 10 patients with no leak, only one reader incorrectly diagnosed a bile leak in a single case (specificity, 98%). The accuracy for detection of the site of leak with Gd-EOB-DTPA-enhanced MR cholangiography was 80%.

Conclusion

Gadolinium-EOB-DTPA–enhanced MR can detect bile leaks with a high sensitivity and specificity.

Copyright © 2014 by Lippincott Williams & Wilkins

 

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