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.
*From the Diagnostic Radiology, The Health Sciences Center, University of Manitoba, Winnipeg, Manitoba, Canada; †Diagnostic Radiology, MRI Department, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada; ‡Division of Abdominal Imaging and Intervention, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; and §Diagnostic Radiology, CT Department, St. Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba, Canada.
Received for publication October 25, 2013; accepted January 29, 2014.
Reprints: Gregory E. Ratcliffe, MD, Postgraduate Year Four, Diagnostic Radiology Residency, University of Manitoba, Department of Radiology, GA216-820 Sherbrook St, Winnipeg, MB R2J 2J8, Canada (e-mail: firstname.lastname@example.org).
The authors declare no conflict of interest.