Movies 1 and 2: Axial VIBE imaging was performed 10 min after intravenous injection of a standard dose of Mn-DPDP (Teslascan, Nycomed). The T1 shortening by the manganese excreted in the biliary system provides high signal intensity on VIBE imaging. Intrahepatic branches of the biliary system are well visualized. This patient has normal biliary anatomy (with lateral branch of right duct normal).

Movie 3: Volume rendered reconstruction of Mn-DPDP cholangiogram shows the lateral branch of the right duct inserting normally.

Aberrant biliary ductal anatomy.

The high prevalence of aberrant biliary ductal anatomy, particularly involving right sided ducts, is a cause of increased morbidity for both the liver transplant donor and recipient. To reduce the operative risks, we perform a comprehensive MR evaluation of donors that includes imaging of the arterial, portal venous, hepatic venous, and biliary anatomy as well as assessment of liver parenchyma. For biliary anatomy, frequently conventional MRCP sequences are inadequate due to the small caliber of intrahepatic biliary ducts. The Mn-DPDP enhanced method allows us to use high resolution VIBE techniques (256 and 512 matrix) to obtain 3D MR cholangiography that then can be easily post-processed with different rendering techniques.

References:

1. Lee VS, Rofsky NM, Morgan GR, Teperman LW, Krinsky GA, Berman P, Weinreb JC. Volumetric mangafodipir-enhanced cholangiography to define intrahepatic biliary anatomy. AJR 2001; 176:906-908.

Location and Date of Scan: New York University Medical Center, New York, 2001
Scanner Model Used: Siemens Symphony with Quantum gradients
Coil Used: Torso phased-array coil
Software version: A11