nach oben

La radiologia medica

Erschienen in:

01.06.2019 | ABDOMINAL RADIOLOGY

Misleading findings of liver-specific MR contrast agent for radiological diagnosis of cysto-biliary communication in hydatid cysts

verfasst von: Fatma Kulali, Aylin Acar, Aslihan Semiz-Oysu, Tolga Canbak, Kerem Tolan, Yasar Bukte

Erschienen in: La radiologia medica | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Objective

To investigate the effectiveness of gadoxetic acid-enhanced magnetic resonance cholangiopancreatography (CE-MRCP) and T2-weighted half-Fourier acquisition single-shot turbo spin-echo (T2W HASTE) sequences for diagnosis of cysto-biliary communication in hydatid cysts compared to surgical results.

Methods

Preoperative abdominal magnetic resonance imaging examinations of patients who underwent surgery for hepatic hydatid cysts were reviewed by two radiologists retrospectively. A total of 45 patients with hydatid cysts were included. Of 45, 27 also had CE-MRCPs. T2W HASTE sequences and CE-MRCPs were investigated separately for cysto-biliary communication. The relationship between radiological and surgical results was analyzed. The interobserver agreement was evaluated.

Results

Of 45 hydatid cysts, there were surgically proven 21 cysts without biliary communications and 24 cysts with biliary communications. All cysts with biliary communications were shown on T2W HASTE sequences. There was no leakage of gadoxetic acid into these cysts (n = 24). Sensitivity, specificity, negative predictive value, positive predictive value (PPV), and accuracy of diagnosis of cyst with biliary communication on T2W HASTE sequences was 100%, 63.64%, 100%, 66.67%, and 78.95%, respectively. Specificity (77.78%), PPV (87.50%), and accuracy (91.30%) were increased in ≥ 10 cm cysts. There was almost perfect interobserver agreement (K = 0.81–1.00).

Conclusion

Leakage of gadoxetic acid inside the cyst indicates biliary communication. However, the lack of leakage does not rule out cysto-biliary communication. When biliary communication is clearly shown on T2W HASTE sequences, it should be reported as cysto-biliary communication even if there is no leakage of gadoxetic acid into the cyst on CE-MRCP.

Salamone G, Licari L, Randisi B, Falco N, Tutino R, Vaglica A, Gullo R, Porello C, Cocorullo G, Gulotta G (2016) Uncommon localizations of hydatid cyst. Review of the literature. G Chir 37(4):180–185PubMedPubMedCentral

Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS (2000) Hydatid disease: radiologic and pathologic features and complications. Radiographics 20(3):795–817CrossRefPubMed

Mihmanli M, Idiz UO, Kaya C, Demir U, Bostanci O, Omeroglu S, Bozkurt E (2016) Current status of diagnosis and treatment of hepatic echinococcosis. World J Hepatol 8(28):1169–1181CrossRefPubMedPubMedCentral

Wen H, Aji T, Shao YM (2010) Diagnosis and management against the complications of human cystic echinococcosis. Front Med China 4(4):394–398. https://doi.org/10.1007/s11684-010-0180-9 CrossRefPubMed

Bakdik S, Arslan S, Oncu F, Tolu I, Eryilmaz MA (2018) Percutaneous treatment of hepatic cystic echinococcosis: the success of alcohol as a single endocavitary agent in PAIR, catheterization, and modified catheterization techniques. Radiol Med 123(2):153–160. https://doi.org/10.1007/s11547-017-0820-0 CrossRefPubMed

Iannicelli E, Di Pietropaolo M, Marignani M, Briani C, Federici GF, DelleFave G, David V (2014) Gadoxetic acid-enhanced MRI for hepatocellular carcinoma and hypointense nodule observed in the hepatobiliary phase. Radiol Med 119(6):367–376. https://doi.org/10.1007/s11547-013-0364-x CrossRefPubMed

Joo I, Lee JM (2016) Recent Advances in the imaging diagnosis of hepatocellular carcinoma: value of gadoxetic acid-enhanced MRI. Liver Cancer 5(1):67–87. https://doi.org/10.1159/000367750 CrossRefPubMed

Kantarci M, Pirimoglu B, Ogul H, Bayraktutan U, Eren S, Aydinli B, Ozturk G, Karaca L (2014) Can biliary-cyst communication be predicted by Gd-EOB-DTPA-enhanced MR cholangiography before treatment for hepatic hydatid disease? Clin Radiol 69(1):52–58. https://doi.org/10.1016/j.crad.2013.08.005 CrossRefPubMed

Schneider G, Altmeyer K, Kirchin MA, Seidel R, Grazioli L, Morana G, Saini S (2007) Evaluation of a novel time-efficient protocol for gadobenate dimeglumine (Gd-BOPTA)-enhanced liver magnetic resonance imaging. Invest Radiol 42:105–115. https://doi.org/10.1097/01.rli.0000251539.05400.06 CrossRefPubMed

10.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRef

11.

Kantarci M, Bayraktutan U, Karabulut N, Aydinli B, Ogul H, Yuce I, Calik M, Eren S, Atamanalp SS, Oto A (2012) Alveolar echinococcosis: spectrum of findings at cross-sectional imaging. Radiographics 32(7):2053–2070. https://doi.org/10.1148/rg.327125708 CrossRefPubMed

12.

El Nakeeb A, Salem A, El Sorogy M, Mahdy Y, Ellatif MA, Moneer A, Said R, El Ghawalby A, Ezzat H (2017) Cystobiliary communication in hepatic hydatid cyst: predictors and outcome. Turk J Gastroenterol 28(2):125–130. https://doi.org/10.5152/tjg.2017.17553 CrossRefPubMed

13.

Hammami A, Hellara O, Mnari W, Loussaief C, Bedioui F, Safer L, Golli M, Chakroun M, Saffar H (2015) Unusual presentation of severely disseminated and rapidly progressive hydatic cyst: malignant hydatidosis. World J Hepatol 7(3):633–637. https://doi.org/10.4254/wjh.v7.i3.633 CrossRefPubMedPubMedCentral

14.

Turgut AT, Altin L, Topcu S, Kilicoglu B, Aliinok T, Kaptanoglu E, Karademir A, Kosar U (2007) Unusual imaging characteristics of complicated hydatid disease. Eur J Radiol 63(1):84–93. https://doi.org/10.1016/j.ejrad.2007.01.00 CrossRefPubMed

15.

Brunetti E, Kern P, Vuitton DA (2010) Writing panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 114(1):1–16. https://doi.org/10.1016/j.actatropica.2009.11.001 CrossRefPubMed

16.

Xie S, Liu C, Yu Z et al (2015) One-stop-shop preoperative evaluation for living liver donors with gadoxetic acid disodium-enhanced magnetic resonance imaging: efficiency and additional benefit. Clin Transplant 29(12):1164–1172CrossRefPubMed

17.

Salvolini L, Urbinati C, Valeri G, Ferrara C, Giovagnoni A (2012) Contrast-enhanced MR cholangiography (MRCP) with GD-EOB-DTPA in evaluating biliary complications after surgery. Radiol Med 117(3):354–368. https://doi.org/10.1007/s11547-011-0731-4 CrossRefPubMed

18.

Kantarcı M, Pirimoglu B, Karabulut N, Bayraktutan U, Ogul H, Ozturk G, Aydinli B, Kizrak Y, Eren S, Yilmaz S (2013) Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography. Eur Radiol 23(10):2713–2722. https://doi.org/10.1007/s00330-013-2880-4 CrossRefPubMedPubMedCentral

19.

Cieszanowski A, Stadnik A, Lezak A, Maj E, Zieniewicz K, Rowinska-Berman K, Grudzinski IP, Krawczyk M, Rowiński O (2013) Detection of active bile leak with Gd-EOB-DTPA enhanced MR cholangiography: comparison of 20-25 min delayed and 60-180 min delayed images. Eur J Radiol 82(12):2176–2182. https://doi.org/10.1016/j.ejrad.2013.08.021 CrossRefPubMed

20.

Alegre Castellanos A, Molina Granados JF, Escribano Fernandez J, Gallardo Muñoz I, Triviño Tarradas FDA (2012) Early phase detection of bile leak after hepatobiliary surgery: value of Gd-EOB-DTPA-enhanced MR cholangiography. Abdom Imaging 37(5):795–802CrossRefPubMed

21.

Kul M, Erden A, Dusunceli AE (2017) Diagnostic value of Gd-EOB-DTPA-enhanced MR cholangiography in non-invasive detection of postoperative bile leakage. Br J Radiol 90(1072):20160847. https://doi.org/10.1259/bjr.20160847 CrossRefPubMedPubMedCentral

22.

Demircan O, Baymus M, Seydaoglu G, Akinoglu A, Sakman G (2006) Occult cystobiliary communication presenting as postoperative biliary leakage after hydatid liver surgery: are there significant preoperative clinical predictors? Can J Surg 49(3):177–184PubMedPubMedCentral

23.

Unalp HR, Baydar B, Kamer E, Yilmaz Y, Issever H, Tarcan E (2009) Asymptomatic occult cysto-biliary communication without bile into cavity of the liver hydatid cyst: a pitfall in conservative surgery. Int J Surg 7(4):387–391. https://doi.org/10.1016/j.ijsu.2009.06.012 CrossRefPubMed

Titel: Misleading findings of liver-specific MR contrast agent for radiological diagnosis of cysto-biliary communication in hydatid cysts
verfasst von: Fatma Kulali
Aylin Acar
Aslihan Semiz-Oysu
Tolga Canbak
Kerem Tolan
Yasar Bukte
Publikationsdatum: 01.06.2019
Verlag: Springer Milan
Erschienen in: La radiologia medica / Ausgabe 6/2019
Print ISSN: 0033-8362
Elektronische ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-019-01000-4

Occupational exposure during endovascular aneurysm repair (EVAR) and aortoiliac percutaneous transluminal angioplasty (PTA) procedures

MEDICAL PHYSICS

Identification of residual–recurrent cholesteatoma in operated ears: diagnostic accuracy of dual-energy CT and MRI

COMPUTED TOMOGRAPHY

Impact factor correlations with Scimago Journal Rank, Source Normalized Impact per Paper, Eigenfactor Score, and the CiteScore in Radiology, Nuclear Medicine & Medical Imaging journals

COMPUTER APPLICATIONS

Intrathyroidal ectopic thymus tissue: a diagnostic challenge

HEAD, NECK AND DENTAL RADIOLOGY

Differentiation between intraspinal schwannoma and meningioma by MR characteristics and clinic features

MAGNETIC RESONANCE IMAGING

Application of ASiR in combination with noise index in the chest CT examination of preschool-age children

CHEST RADIOLOGY

Neu im Fachgebiet Radiologie

KI-gestütztes Mammografiescreening überzeugt im Praxistest

16.01.2025
Künstliche Intelligenz im Gesundheitswesen
Nachrichten

Mit dem Einsatz künstlicher Intelligenz lässt sich die Detektionsrate im Mammografiescreening offenbar deutlich steigern. Mehr unnötige Zusatzuntersuchungen sind laut der Studie aus Deutschland nicht zu befürchten.

Stumme Schlaganfälle − ein häufiger Nebenbefund im Kopf-CT?

12.01.2025
Computertomografie
Nachrichten

In 4% der in der Notfallambulanz initiierten zerebralen Bildgebung sind „alte“ Schlaganfälle zu erkennen. Gar nicht so selten handelt es sich laut einer aktuellen Studie dabei um unbemerkte Insulte. Bietet sich hier womöglich die Chance auf ein effektives opportunistisches Screening?

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Stören weiße Wände und viel Licht die Bildqualitätskontrolle?

09.01.2025
Mammografie
Nachrichten

Wenn es darum geht, die technische Qualität eines Mammogramms zu beurteilen, könnten graue Wandfarbe und reduzierte Beleuchtung im Bildgebungsraum von Vorteil sein. Darauf deuten zumindest Ergebnisse einer kleinen Studie hin.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Misleading findings of liver-specific MR contrast agent for radiological diagnosis of cysto-biliary communication in hydatid cysts