Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography
Abstract Expanding bile leaks after blunt liver trauma require more aggressive treatment than contained bile leaks. In this retrospective study approved by institution review board, we analyzed if non-invasive contrast-enhanced magnetic resonance cholangiography (CEMRC) using hepatocyte-specific con...
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Nature Portfolio
2018-10-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-018-32976-0 |
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| author | Yon-Cheong Wong Li-Jen Wang Cheng-Hsien Wu Huan-Wu Chen Chen-Ju Fu Kuo-Ching Yuan Being-Chuan Lin Yu-Pao Hsu Shih-Ching Kang |
| author_facet | Yon-Cheong Wong Li-Jen Wang Cheng-Hsien Wu Huan-Wu Chen Chen-Ju Fu Kuo-Ching Yuan Being-Chuan Lin Yu-Pao Hsu Shih-Ching Kang |
| author_sort | Yon-Cheong Wong |
| collection | DOAJ |
| description | Abstract Expanding bile leaks after blunt liver trauma require more aggressive treatment than contained bile leaks. In this retrospective study approved by institution review board, we analyzed if non-invasive contrast-enhanced magnetic resonance cholangiography (CEMRC) using hepatocyte-specific contrast agent (gadoxetic acid disodium) could detect and characterize traumatic bile leaks. Between March 2012 and December 2014, written informed consents from 22 included patients (17 men, 5 women) with a median age of 24.5 years (IQR 21.8, 36.0 years) were obtained. Biliary tree visualization and bile leak detection on CEMRC acquired at 10, 20, 30, 90 minutes time points were independently graded by three radiologists on a 5-point Likert scale. Intraclass Correlation (ICC) was computed as estimates of interrater reliability. Accuracy was measured by area under receiver operating characteristic curves (AUROC). Biliary tree visualization was the best on CEMRC at 90 minutes (score 4.30) with excellent inter-rater reliability (ICC = 0.930). Of 22 CEMRC, 15 had bile leak (8 expanding, 7 contained). The largest AUROC of bile leak detection by three radiologists were 0.824, 0.914, 0.929 respectively on CEMRC at 90 minutes with ICC of 0.816. In conclusion, bile leaks of blunt liver trauma can be accurately detected and characterized on CEMRC. |
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| publishDate | 2018-10-01 |
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| spelling | doaj.art-7f09400d77d243eaa3633f8a6976b1b62022-12-21T21:51:47ZengNature PortfolioScientific Reports2045-23222018-10-01811910.1038/s41598-018-32976-0Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiographyYon-Cheong Wong0Li-Jen Wang1Cheng-Hsien Wu2Huan-Wu Chen3Chen-Ju Fu4Kuo-Ching Yuan5Being-Chuan Lin6Yu-Pao Hsu7Shih-Ching Kang8Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung UniversityEmergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung UniversityEmergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung UniversityEmergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung UniversityEmergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung UniversityDivision of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung UniversityAbstract Expanding bile leaks after blunt liver trauma require more aggressive treatment than contained bile leaks. In this retrospective study approved by institution review board, we analyzed if non-invasive contrast-enhanced magnetic resonance cholangiography (CEMRC) using hepatocyte-specific contrast agent (gadoxetic acid disodium) could detect and characterize traumatic bile leaks. Between March 2012 and December 2014, written informed consents from 22 included patients (17 men, 5 women) with a median age of 24.5 years (IQR 21.8, 36.0 years) were obtained. Biliary tree visualization and bile leak detection on CEMRC acquired at 10, 20, 30, 90 minutes time points were independently graded by three radiologists on a 5-point Likert scale. Intraclass Correlation (ICC) was computed as estimates of interrater reliability. Accuracy was measured by area under receiver operating characteristic curves (AUROC). Biliary tree visualization was the best on CEMRC at 90 minutes (score 4.30) with excellent inter-rater reliability (ICC = 0.930). Of 22 CEMRC, 15 had bile leak (8 expanding, 7 contained). The largest AUROC of bile leak detection by three radiologists were 0.824, 0.914, 0.929 respectively on CEMRC at 90 minutes with ICC of 0.816. In conclusion, bile leaks of blunt liver trauma can be accurately detected and characterized on CEMRC.https://doi.org/10.1038/s41598-018-32976-0Bile LeakageContrast-enhanced Magnetic Resonance Cholangiography (CEMRC)Area Under Receiver Operating Characteristics Curve (AUROC)Detect Bile LeaksGadoxetic Acid Disodium |
| spellingShingle | Yon-Cheong Wong Li-Jen Wang Cheng-Hsien Wu Huan-Wu Chen Chen-Ju Fu Kuo-Ching Yuan Being-Chuan Lin Yu-Pao Hsu Shih-Ching Kang Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography Scientific Reports Bile Leakage Contrast-enhanced Magnetic Resonance Cholangiography (CEMRC) Area Under Receiver Operating Characteristics Curve (AUROC) Detect Bile Leaks Gadoxetic Acid Disodium |
| title | Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography |
| title_full | Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography |
| title_fullStr | Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography |
| title_full_unstemmed | Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography |
| title_short | Detection and characterization of traumatic bile leaks using Gd-EOB-DTPA enhanced magnetic resonance cholangiography |
| title_sort | detection and characterization of traumatic bile leaks using gd eob dtpa enhanced magnetic resonance cholangiography |
| topic | Bile Leakage Contrast-enhanced Magnetic Resonance Cholangiography (CEMRC) Area Under Receiver Operating Characteristics Curve (AUROC) Detect Bile Leaks Gadoxetic Acid Disodium |
| url | https://doi.org/10.1038/s41598-018-32976-0 |
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