From the Guidelines
Hepatobiliary contrast agents, such as those with biliary excretion, are typically given during Magnetic Resonance Cholangiopancreatography (MRCP) to provide functional assessment of the biliary tree and detect bile leaks with high accuracy 1.
Key Points
- MRCP with hepatobiliary contrast agents can identify bile leaks and provide exact anatomical diagnosis of the biliary tree 1.
- The use of contrast-enhanced MRCP (CE-MRCP) with 3D and 2D T1-weighted images acquired at the hepatobiliary phase after hepato-specific contrast agent injection improves the accuracy of bile anatomy depiction and bile leak detection 1.
- Hepatobiliary contrast agents, such as mangafodipir trisodium, are primarily excreted via bile and can be used to diagnose bile leaks and identify the source of the leak by direct visualization of contrast material extravasation into fluid collections 1.
Contrast Agents
- Mangafodipir trisodium is an example of a hepatobiliary contrast agent that can be used for MRCP, although it is no longer available in the EU market 1.
- Other hepatobiliary contrast agents with biliary excretion can be used as alternatives to provide functional assessment of the biliary tree and detect bile leaks 1.
From the Research
Type of Contrast Used in MRCP
- No contrast material is required for MRCP, as it is a noninvasive technique that uses heavily T2-weighted sequences to highlight static fluids in the biliary and pancreatic ducts 2.
- However, negative oral contrast agents can be used to suppress the signal from the gastrointestinal tract and improve the visualization of the bile and pancreatic ducts 3, 4, 5.
- Examples of negative oral contrast agents used in MRCP include:
- It's worth noting that the use of negative oral contrast agents can be beneficial in certain cases, but it's not always necessary, and the choice of contrast agent may depend on the specific clinical scenario and patient factors 3, 4, 5.