Contrast-enhanced MR cholangiography with Gd-EOB-DTPA for preoperative biliary mapping: correlation with intraoperative cholangiography

Abstract

Background Gd-EOB-DTPA-enhanced magnetic resonance (MR) could be used for preoperative evaluation of bile duct anatomy in addition to conventional information of focal hepatic lesions. Purpose To evaluate accuracy of contrast-enhanced MR cholangiography (CE MRC) reconstructed from Gd-EOB-DTPA-enhanced MR images for depicting biliary anatomy with intraoperative cholangiography. Material and Methods We retrospectively identified 71 patients who underwent both preoperative Gd-EOB-DTPA-enhanced MR imaging (MRI) and intraoperative cholangiography for hepatic resections. Two readers independently analyzed biliary anatomy using CE MRC reconstructed from transverse and coronal images separately in 4 weeks. The accuracy and diagnostic confidence were evaluated in correlation with intraoperative cholangiography. The accuracy and confidence score (3-point scale) were compared on CE MRCs from transverse versus coronal images. Results CE MRCs correctly depicted biliary anatomy in 91.5% and 88.7% with coronal images and in 81.7% and 73.2% with transverse images for readers 1 and 2, respectively. CE MRCs from coronal images tended to show greater accuracy ( P = 0.12 and 0.01, for readers 1 and 2) and higher confidence score ( P = 0.11 and P = 0.04, for readers 1 and 2) than those from transverse images. Conclusion Accurate preoperative biliary mapping can be achieved on CE MRC reconstructed from Gd-EOB-DTPA-enhanced MR images. The diagnostic performance was better on CE MRC reconstructed from coronal than those from transverse images.