Cholangiography before biliary surgery: Single-shot MR cholangiography versus intravenous cholangiography

PURPOSE: To compare depiction of the biliary tract with magnetic resonance (MR) and intravenous cholangiography before biliary surgery. MATERIALS AND METHODS: Intravenous cholangiograms and heavily T2-weighted single-shot MR images in 60 patients with biliary calculi were compared prospectively. Images obtained with each technique were independently assessed for depiction of anatomy and calculi. RESULTS: The gallbladder was adequately visualized with intravenous cholangiography in 77% of patients and with MR cholangiography in 88%. Rates for visualization of the common bile duct were 97% and 100%, respectively; for the cystic duct, 27% and 75%; and intrahepatic ducts, 28% and 77%. With either technique, calculi in the gallbladder were correctly predicted as solitary or multiple in approximately 80% of patients. Five cases of common bile duct calculi were correctly predicted with this technique, two cases with cystic duct calculi were depicted with only MR cholangiography. CONCLUSION: Single-shot MR cholangiography may replace intravenous cholangiography for visualization of the biliary tract. However, the delineation of tiny gallbladder calculi and shrunken gallbladders with thickened bile is limited.