Jörg F. Debatin

To prospectively evaluate the feasibility of postoperative contrast enhanced Multi-detector-CT cholangiography (ceMDCT-CA) in living liver donors and transplant recipients. Fifteen donors and 11 recipients of a right hepatic lobe underwent ceMDCT-CA. Six donors were admitted to exclude biliary leakage; 9 donors and 11 recipients were examined to exclude postoperative biliary obstruction. The examination protocol included the intravenous short-infusion of 100 mL of a biliary contrast agent. CT cholangiography data was acquired with a slice thickness of 1 mm. This scan was followed by examination of the upper abdomen in a venous phase. Data sets were evaluated quantitatively by measurement of the biliary opacification, and qualitatively on the basis of a scale ranging from 1 (non-diagnostic) to 4 (excellent). Opacification was correlated with postoperative serum bilirubin level. CT data provided diagnostic delineation of the biliary tree in all 15 donors and seven of 11 recipients; in 4 recipients the degree of biliary opacification was non-diagnostic. Biliary opacification was generally higher in the donor collective. Four donors and 3 recipients presented a moderate focal biliary constriction without elevation of laboratory values. Six patients showed postoperative fluid collections suggestive of perihepatic biloma, however no biliary fistula could be visualized. CeMDCT-CA represents a promising tool to non-invasively assess the postoperative biliary morphology in living liver donors and transplant recipients.

Colorectal cancer screening has vast potential. Beyond considerations for cost and diagnostic accuracy, the effectiveness of any colorectal screening strategy will be dependent on the degree of patient acceptance. Magnetic resonance (MR) colonography has been shown to be accurate regarding the detection of clinically relevant colonic polyps exceeding 10 mm in size, with reported sensitivity and specificity values exceeding 95%. To further increase patient acceptance, strategies for fecal tagging have recently been developed. By modulating the signal of fecal material to be identical to the signal characteristics of the enema applied to distend the colon, fecal tagging in conjunction with MR colonography obviates the need for bowel cleansing. The review will describe the techniques underlying MR colonography and describe early clinical experience with fecal tagging techniques.

OBJECTIVE. The purpose of our study was to evaluate the feasibility and accuracy of three-dimensional (3D) volumetric interpolated breath-hold whole-body MR imaging using CT and nuclear medicine techniques as the standard of reference in patients with metastases. CONCLUSION. The 3D volumetric interpolated breath-hold whole-body MR imaging examination for metastases screening correlates well with CT and scintigraphy. The use of the rolling table platform permits rapid whole-body imaging in an average of 11 min. The preliminary results indicate that the described technique has the potential to emerge as an all-encompassing alternative to conventional multimodality tumor staging strategies.