Gadoxetic acid-enhanced T1-weighted MR cholangiography in primary sclerosing cholangitis

To investigate the value of gadoxetic acid-enhanced three-dimensional T1-weighted MR cholangiography (T1w-MRC) in comparison to three-dimensional T2-weighted MR cholangiopancreaticography (T2w-MRCP) in patients with primary sclerosing cholangitis (PSC).

Thirty-four MR exams in 29 patients (46.0 ± 16.1 years; 19 men, 10 women) scanned within a 14-month period were retrospectively included. Two abdominal radiologists independently evaluated image quality regarding image contrast, image quality degradation due to artifacts, and visualization quality of ducts. The order of biliary tree branches that were visualized and reader preference toward each method were recorded. Helpfulness of T1w-MRC was scored in consensus. Confirmatory endoscopic retrograde cholangiopancreaticography (ERCP) performed within 3 months of the MR examination was available in 8 patients.

Image quality of T1w-MRC and T2w-MRCP was graded good to excellent in all cases. There were advantages for both T1w-MRC (functional information, less degradation due to artifacts) and T2w-MRCP (higher order of visualized branches, better branch depiction). Both readers showed preference for T2w-MRCP; however, both readers found gadoxetic acid-enhanced T1w-MRC helpful in the majority of cases.

Gadoxetic acid-enhanced T1w-MRC is complementary to, but should not replace, T2w-MRCP. T1w-MRC is a useful adjunct to T2w-MRCP for morphologic evaluation and provides additional diagnostic information.