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MR cholangiography in neonates and infants: feasibility and preliminary applications
L Guibaud1, A Lachaud, R Touraine
1Pediatric Imaging Department, Hôpital Debrousse, Université Lyon-Sud, France.
Objective:
The objective of the study was to evaluate the accuracy of MR cholangiography in showing the biliary tree in neonates and infants and to show preliminary applications in a pediatric population.
Subjects And Methods:
MR cholangiography was performed with T2-weighted turbo spin-echo sequences (8000/300 [TR/TE], six or eight excitations). The study included seven patients with suspected bile duct disorders and 10 control individuals.
Results:
In the control group, the extrahepatic bile ducts (EHBDs) were revealed by MR cholangiography in all patients. In one of the five patients with neonatal cholestasis, biliary atresia was excluded by identifying the entire EHBD on MR cholangiograms. In the four other patients with neonatal cholestasis, biliary atresia was suspected because the EHBD could not be seen on MR cholangiography. The diagnosis was confirmed in three of these four patients, in whom the MR finding was associated with significant periportal thickening. In the remaining patient, in whom periportal thickening was not seen, sclerosing cholangitis was diagnosed on biopsy. In the sixth patient with neonatal cholestasis, who had received a liver transplant, MR cholangiography showed biliary dilatation above the biliary-digestive anastomosis. In the seventh patient, a neonate with a prenatal diagnosis of hepatic cyst, MR cholangiography showed a choledochal cyst.
Conclusion:
MR cholangiography may become an important diagnostic tool in the detection of biliary atresia, congenital choledochal dilatation, and biliary complications in hepatic transplantation for pediatric patients.
Insights
Magnetic resonance cholangiography accurately visualizes the biliary tree in infants. This technique aids in diagnosing conditions like biliary atresia and choledochal cysts in pediatric patients.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Gastroenterology
Background:
- Accurate visualization of the pediatric biliary tree is crucial for diagnosing congenital and acquired disorders.
- Non-invasive imaging modalities are preferred for evaluating neonates and infants.
Purpose of the Study:
- To assess the diagnostic accuracy of MR cholangiography (MRC) in visualizing the biliary tree in neonates and infants.
- To explore the preliminary applications of MRC in a pediatric population.
Main Methods:
- MRC was performed using T2-weighted turbo spin-echo sequences.
- The study included seven patients with suspected bile duct disorders and ten control individuals.
Main Results:
- The extrahepatic bile ducts (EHBDs) were visualized in all control subjects.
- MRC successfully excluded biliary atresia in one patient and suspected it in four others.
- Dilatation above a biliary-digestive anastomosis and a choledochal cyst were identified in transplant and neonate patients, respectively.
Conclusions:
- MR cholangiography demonstrates significant potential as a diagnostic tool for pediatric biliary conditions.
- MRC is valuable for detecting biliary atresia, congenital choledochal dilatation, and complications post-hepatic transplantation.