| Assessment of acute cholangitis by MR imaging. | |
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MedLine Citation:
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PMID: 22088387 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: The purpose of this study is to assess the common MRI findings of acute cholangitis compared with those of non-acute cholangitis. MATERIALS AND METHODS: During a 31-month period, we performed MRCP and contrast-enhanced MRI on 173 patients with biliary abnormalities including duct dilatation or stricture. The causes of the biliary abnormalities included biliary stone disease (n=85), cholangiocarcinoma (n=47), periampullary cancer (n=20), GB cancer (n=4), and others (n=17). Among 173 patients, 66 consecutive patients were confirmed with acute cholangitis diagnosed according to the Tokyo guideline, and 107 patients were confirmed as having non-acute cholangitis. Two radiologists retrospectively and independently accessed the MR findings, including the cause of biliary abnormality, increased periductal signal intensity on T2-weighted images, the transient periductal signal difference, and the presence of abscess, thrombosis, and ragged duct. They also measured the dilated duct and the thickened wall. The Student t-test and the Pearson chi-square were used. The κ statistics were used to determine interobserver agreement. Logistic regression was used to identify the MR findings that predicted acute cholangitis. RESULTS: MRI correctly accessed the cause of biliary abnormality in 163 patients (94%). The statistically common findings for acute cholangitis were as follows: increased periductal signal intensity on T2-weighted imaging (n=26, 39%, p<0.05); transient periductal signal difference (n=31, 47%, p<0.05); abscess (n=18, 27%, p<0.05); thrombosis (n=12, 18%, p<0.05); and ragged duct (n=11, 17%, p<0.05). Interobserver agreement was good to excellent for each finding (κ=0.74-0.97). The wall thickness showed a statistically significant difference between the acute cholangitis and the non-acute cholangitis group (2.65mm:2.32mm, p<0.05), however, there was no significant difference in duct dilatation in the two groups. The periductal transient attenuation difference was an independent predictor of acute cholangitis (Exp (B)=6.389, p=0.018). CONCLUSION: MRI accurately assesses the cause of biliary abnormality in patients with cholangitis. Using statistically common MR findings for acute cholangitis, MR imaging is very successful in predicting acute cholangitis. |
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Authors:
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Hyo Won Eun; Jung Hoon Kim; Seong Sook Hong; Young Jae Kim |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-14 |
Journal Detail:
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Title: European journal of radiology Volume: - ISSN: 1872-7727 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106411 Medline TA: Eur J Radiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Health Promotion Center, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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