Using Kinematic MR Cholangiopancreatography to Evaluate Biliary Dilatation
Joo Hee Kim1,
Myeong-Jin Kim1,2,
Sung IL Park1,
Jae-Joon Chung1,
Si Young Song3,
Hyung Sik Yoo1 and
Jong Tae Lee1
1
Department of Diagnostic Radiology, Research Institute of Radiological
Science, Yonsei University College of Medicine, Seodaemun-ku Shinchon-dong
134, Seoul 120-752, Republic of Korea.
2
Brain Korea 21 Project for Medical Science, Yonsei University College of
Medicine, Seoul 120-752, Republic of Korea.
3
Division of Gastroenterology, Department of Internal Medicine, Yonsei
University College of Medicine, Seoul 120-752, Republic of Korea.
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Fig. 1. —Schematic drawing shows classification of shapes of distal
common bile duct seen on kinematic MR cholangiopancreatography.
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Fig. 2A. —56-year-old woman with benign ampullary stricture (group I).
Kinematic MR cholangiopancreatographic images reveal persistently contracted
ampullary segment without sphincteric relaxation. Distal end of common bile
duct shows both bird's beak (arrow, A) and blunted shapes
(arrowhead, B).
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Fig. 2B. —56-year-old woman with benign ampullary stricture (group I).
Kinematic MR cholangiopancreatographic images reveal persistently contracted
ampullary segment without sphincteric relaxation. Distal end of common bile
duct shows both bird's beak (arrow, A) and blunted shapes
(arrowhead, B).
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Fig. 3. —Kinematic MR cholangiopancreatographic image of 41-year-old
man with stone-related ampullary stenosis (group I) shows contraction of
sphincteric segment (arrow), which persisted on all consecutive
images. Stone (arrowhead) is visible in dilated common bile duct.
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Fig. 4A. —57-year-old man with an ampullary carcinoma (group I).
Kinematic MR cholangiopancreatographic images show alternate contraction
(A) and relaxation (B) of sphincteric segment. However, degree
of relaxation of sphincteric segment seems to be incomplete. Diameter of
relaxed sphincteric segment was found to abruptly become more narrow than
adjacent common bile duct (arrow, B).
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Fig. 4B. —57-year-old man with an ampullary carcinoma (group I).
Kinematic MR cholangiopancreatographic images show alternate contraction
(A) and relaxation (B) of sphincteric segment. However, degree
of relaxation of sphincteric segment seems to be incomplete. Diameter of
relaxed sphincteric segment was found to abruptly become more narrow than
adjacent common bile duct (arrow, B).
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Fig. 5. —Kinematic MR cholangiopancreatographic image of 63-year-old
man with Klatskin's tumor (group II). All 20 of this patient's serial
kinematic images showed relaxed sphincteric segment (arrow).
Dilatation of intrahepatic bile ducts is seen above the hilar obstruction
(arrowhead).
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Fig. 6A. —64-year-old woman with gallstones (not shown) and biliary
dilatation (group III). Kinematic MR cholangiopancreatographic images obtained
in this patient revealed intermittent but complete relaxation (arrow,
D) of the distal common bile duct on several images. Appearance of
distal end of common bile duct varies: blunted (A), papillary (B
and C), and tapered (D). Suspicion that patient had obstructive
lesion at distal end of common bile duct had been based on evidence seen on
conventional static image (not shown).
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Fig. 6B. —64-year-old woman with gallstones (not shown) and biliary
dilatation (group III). Kinematic MR cholangiopancreatographic images obtained
in this patient revealed intermittent but complete relaxation (arrow,
D) of the distal common bile duct on several images. Appearance of
distal end of common bile duct varies: blunted (A), papillary (B
and C), and tapered (D). Suspicion that patient had obstructive
lesion at distal end of common bile duct had been based on evidence seen on
conventional static image (not shown).
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Fig. 6C. —64-year-old woman with gallstones (not shown) and biliary
dilatation (group III). Kinematic MR cholangiopancreatographic images obtained
in this patient revealed intermittent but complete relaxation (arrow,
D) of the distal common bile duct on several images. Appearance of
distal end of common bile duct varies: blunted (A), papillary (B
and C), and tapered (D). Suspicion that patient had obstructive
lesion at distal end of common bile duct had been based on evidence seen on
conventional static image (not shown).
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Fig. 6D. —64-year-old woman with gallstones (not shown) and biliary
dilatation (group III). Kinematic MR cholangiopancreatographic images obtained
in this patient revealed intermittent but complete relaxation (arrow,
D) of the distal common bile duct on several images. Appearance of
distal end of common bile duct varies: blunted (A), papillary (B
and C), and tapered (D). Suspicion that patient had obstructive
lesion at distal end of common bile duct had been based on evidence seen on
conventional static image (not shown).
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Copyright © 2002 by the American Roentgen Ray Society.
