Experience in Using Direct Magnetic Resonance Cholangiography and Fistulography in the Diagnosis of Cholelithiasis Complications and Postoperative Treatment for Choledocholithiasis

The article presents four clinical observations of patients who underwent contrast-enhanced magnetic resonance imaging (MRI) after treatment for cholelithiasis complicated by choledocholithiasis. Abdominal MRI was performed using Amira 1.5T MR tomograph (Siemens, Germany) according to standard protocols with subsequent injection of contrast agent in the form of 20 ml of paramagnetic (Omniscan®) diluted in 50 ml of saline solution: in three patients – into the common bile duct drainage tubes, and in one patient – through a probe inserted into the fistulous tract of the anterior abdominal wall. It was shown that dilution of 20 ml of Omniscan® in 50 ml of saline solution to increase the volume of the contrast agent does not significantly affect MR properties of the paramagnetic. The technique allowed identifying the patency of extrahepatic bile ducts and showed high potential in detecting bile discharge as a complication of surgical treatment for choledocholithiasis, but it did not visualize directly the lumen of drainage tubes and fistula passages, which requires further improvement.

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