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Ability of MR Cholangiography to Reveal Stent Position and Luminal Diameter in Patients with Biliary Endoprostheses

In Vitro Measurements and In Vivo Results in 30 Patients

¹ Department of Radiology, University Hospitals of Ulm, Robert Koch Str. 8, 89081 Ulm, Germany.
² Department of Internal Medicine I, University Hospitals of Ulm, 89081 Ulm, Germany.

OBJECTIVE. Our goal was to evaluate the ability of MR cholangiography to show stent position and luminal diameter in patients with biliary endoprostheses.

MATERIALS AND METHODS. Susceptibility artifacts were evaluated in vitro in three different stent systems (cobalt alloy—based, nitinol-based, and polyethylene) using two breath-hold sequences (rapid acquisition with relaxation enhancement, half-Fourier acquisition single-shot turbo spin echo) on a 1.5-T MR imaging system. The size of the stent-related artifact was measured, and the relative stent lumen was calculated. In vivo stent position and patency were determined in 30 patients (10 cobalt alloy—based stents, five nitinol-based stents, and 15 polyethylene stents).

RESULTS. In vitro, the susceptibility artifact of the cobalt stent caused complete obliteration of the stent lumen. The relative stent lumens of the nitinol-based and polyethylene stents were 38-50% and 67-100%, respectively. In vivo, all stents were patent at the time of imaging. The position of the cobalt alloy—based stent could be determined in nine of 10 patients, but stent patency could not be evaluated. Stent position of nitinol stents could not be adequately evaluated in any of the five patients, and internal stent diameter could be visualized in only one patient. In nine of 15 patients, the fluid column within the implanted polyethylene stent was seen on MR cholangiography.

CONCLUSION. The internal stent lumen could be visualized in most patients with an indwelling polyethylene stent, but not in patients with cobalt alloy— or nitinol-based stents.

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