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MR Cholangiography with Manganese Dipyridoxyl Diphosphate in the Evaluation of Biliary–Enteric Anastomoses: Preliminary Experience

Nathalie Hottat1, Catherine Winant1, Thierry Metens1, Nadine Bourgeois2, Jacques Devière2 and Celso Matos1

1 Department of Radiology, Hôpital Erasme, University Clinics of Brussels, Free University of Brussels, Route de Lennik, 808, Brussels B-1070, Belgium.
2 Department of Gastroenterology, Hôpital Erasme, University Clinics of Brussels, Free University of Brussels, Brussels, Belgium.



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  		Fig. 1A. —An asymptomatic 60-year-old woman with normal hepaticojejunostomy due to primary sclerosing cholangitis (patient 10). Coronal T2-weighted projection shows normal aspect of biliary-enteric anastomoses (thin arrow) and dilated irregular left intrahepatic bile ducts (large arrow) suggesting cholangitis.

 


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  		Fig. 1B. —An asymptomatic 60-year-old woman with normal hepaticojejunostomy due to primary sclerosing cholangitis (patient 10). Coronal enhanced T1-weighted 3D gradient-echo image shows contrast media in biliary-enteric anastomoses (thin arrow) 1 hr after IV administration.

 


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  		Fig. 2A. —50-year-old man with biliary–enteric anastomoses due to orthotopic liver transplantation performed because of primary sclerosing cholangitis (patient 6). Coronal (A) and axial (B) T2-weighted projections show dilated irregular intrahepatic bile ducts (arrowheads, A and B) and a signal void between biliary ducts and fluid-filled jejunal loop (arrow, A), which suggests biliary obstruction.

 


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  		Fig. 2B. —50-year-old man with biliary–enteric anastomoses due to orthotopic liver transplantation performed because of primary sclerosing cholangitis (patient 6). Coronal (A) and axial (B) T2-weighted projections show dilated irregular intrahepatic bile ducts (arrowheads, A and B) and a signal void between biliary ducts and fluid-filled jejunal loop (arrow, A), which suggests biliary obstruction.

 


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  		Fig. 2C. —50-year-old man with biliary–enteric anastomoses due to orthotopic liver transplantation performed because of primary sclerosing cholangitis (patient 6). Axial enhanced T1-weighted images (C–E) and corresponding maximum-intensity-projection image (F) show predominant left dilated intrahepatic bile ducts (arrowheads, C and F), contrast-filled biliary–enteric anastomoses (thin arrows, D and F), and jejunal loop (large arrow, F), thus indicating patency.

 


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  		Fig. 2D. —50-year-old man with biliary–enteric anastomoses due to orthotopic liver transplantation performed because of primary sclerosing cholangitis (patient 6). Axial enhanced T1-weighted images (C–E) and corresponding maximum-intensity-projection image (F) show predominant left dilated intrahepatic bile ducts (arrowheads, C and F), contrast-filled biliary–enteric anastomoses (thin arrows, D and F), and jejunal loop (large arrow, F), thus indicating patency.

 


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  		Fig. 3A. —Asymptomatic 51-year-old woman with biliary–enteric anastomoses due to orthotopic liver transplantation (patient 3). Axial (A) and coronal (B) T2-weighted projections show biliary cysts, dilated bile ducts (arrowheads), multiple intrahepatic strictures (thin arrows) and the presence of signal at level of biliary-enteric anastomoses (large arrow).

 


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  		Fig. 3B. —Asymptomatic 51-year-old woman with biliary–enteric anastomoses due to orthotopic liver transplantation (patient 3). Axial (A) and coronal (B) T2-weighted projections show biliary cysts, dilated bile ducts (arrowheads), multiple intrahepatic strictures (thin arrows) and the presence of signal at level of biliary-enteric anastomoses (large arrow).

 


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  		Fig. 3C. —Asymptomatic 51-year-old woman with biliary–enteric anastomoses due to orthotopic liver transplantation (patient 3). Coronal enhanced T1-weighted images show a patent biliary-enteric anastomoses (thin arrows).

 


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  		Fig. 3D. —Asymptomatic 51-year-old woman with biliary–enteric anastomoses due to orthotopic liver transplantation (patient 3). Coronal enhanced T1-weighted images show a patent biliary-enteric anastomoses (thin arrows).

 


View larger version (139K):

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  		Fig. 2E. —50-year-old man with biliary–enteric anastomoses due to orthotopic liver transplantation performed because of primary sclerosing cholangitis (patient 6). Axial enhanced T1-weighted images (C–E) and corresponding maximum-intensity-projection image (F) show predominant left dilated intrahepatic bile ducts (arrowheads, C and F), contrast-filled biliary–enteric anastomoses (thin arrows, D and F), and jejunal loop (large arrow, F), thus indicating patency.

 


View larger version (123K):

[in a new window]
  		Fig. 2F. —50-year-old man with biliary–enteric anastomoses due to orthotopic liver transplantation performed because of primary sclerosing cholangitis (patient 6). Axial enhanced T1-weighted images (C–E) and corresponding maximum-intensity-projection image (F) show predominant left dilated intrahepatic bile ducts (arrowheads, C and F), contrast-filled biliary–enteric anastomoses (thin arrows, D and F), and jejunal loop (large arrow, F), thus indicating patency.

 

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