Adult bile duct strictures: role of MR imaging and MR cholangiopancreatography in characterization.

Abstract

Bile duct strictures in adults are secondary to a wide spectrum of benign and malignant pathologic conditions. Benign causes of bile duct strictures include iatrogenic causes, acute or chronic pancreatitis, choledocholithiasis, primary sclerosing cholangitis, IgG4-related sclerosing cholangitis, liver transplantation, recurrent pyogenic cholangitis, Mirizzi syndrome, acquired immunodeficiency syndrome cholangiopathy, and sphincter of Oddi dysfunction. Malignant causes include cholangiocarcinoma, pancreatic adenocarcinoma, and periampullary carcinomas. Rare causes include biliary inflammatory pseudotumor, gallbladder carcinoma, hepatocellular carcinoma, metastases to bile ducts, and extrinsic bile duct compression secondary to periportal or peripancreatic lymphadenopathy. Contrast material-enhanced magnetic resonance (MR) imaging with MR cholangiopancreatography is extremely helpful in the noninvasive evaluation of patients with obstructive jaundice, an obstructive pattern of liver function, or incidentally detected biliary duct dilatation. Some of these conditions may show characteristic findings at MR imaging-MR cholangiopancreatography that help in making a definitive diagnosis. Although endoscopic retrograde cholangiopancreatography with tissue biopsy or surgery is needed for the definitive diagnosis of many of these strictures, certain MR imaging characteristics of the narrowed segment (eg, thickened wall, long-segment involvement, asymmetry, indistinct outer margin, luminal irregularity, hyperenhancement relative to the liver parenchyma) may favor a malignant cause. Awareness of the various causes of bile duct strictures in adults and familiarity with their appearances at MR imaging-MR cholangiopancreatography are important for accurate diagnosis and optimal patient management.

• Authors: Venkata S Katabathina, Anil K Dasyam, Navya Dasyam, Keyanoosh Hosseinzadeh
• Journal: Radiographics : a review publication of the Radiological Society of North America, Inc (Radiographics) 2014 May-Jun Vol. 34 Issue 3 Pg. 565-86 ISSN: 1527-1323 [Electronic] United States
• PMID: 24819781 (Publication Type: Journal Article, Review)
• Copyright: RSNA, 2014

Topics

• Acquired Immunodeficiency Syndrome (complications)
• Adult
• Ampulla of Vater (diagnostic imaging, pathology)
• Bile Duct Diseases (complications, diagnosis, diagnostic imaging, pathology)
• Bile Ducts (pathology)
• Bile Ducts, Intrahepatic (diagnostic imaging, pathology)
• Cholangiocarcinoma (complications, diagnosis)
• Cholangiopancreatography, Endoscopic Retrograde
• Cholangiopancreatography, Magnetic Resonance (methods)
• Constriction, Pathologic (diagnosis, etiology)
• Humans
• Jaundice, Obstructive (diagnosis, etiology)
• Magnetic Resonance Imaging (methods)
• Pancreatic Neoplasms (complications, diagnosis)
• Postoperative Complications (diagnosis)