Résumé
To assess the value of MRI in the diagnosis of portal cavernoma with biliary obstruction.PURPOSETo assess the value of MRI in the diagnosis of portal cavernoma with biliary obstruction.and methods: six patients referred for clinical suspicion of biliary obstruction and portal cavernoma were explored with MRI. all patients were explored using a signa 1.5 t GE MR unit, with high gradient field strength and torso phased array coil. Biliary ducts were explored with ss-fse sequences of MR-cholangiopancreatography (MRCP), coronal and oblique coronal 20mm thick slices. Then, coronal T2w with shorter TE eff, MR-angiography and delayed T1w sequences were performed. CT scan and sonographic examinations of the liver were performed in all patients. Two patients were operated on and 2 underwent endoscopic retrograde cholangiography.MATERIALand methods: six patients referred for clinical suspicion of biliary obstruction and portal cavernoma were explored with MRI. all patients were explored using a signa 1.5 t GE MR unit, with high gradient field strength and torso phased array coil. Biliary ducts were explored with ss-fse sequences of MR-cholangiopancreatography (MRCP), coronal and oblique coronal 20mm thick slices. Then, coronal T2w with shorter TE eff, MR-angiography and delayed T1w sequences were performed. CT scan and sonographic examinations of the liver were performed in all patients. Two patients were operated on and 2 underwent endoscopic retrograde cholangiography.Three different types of biliary involvement were found: in 3 cases findings that mimic cholangiocarcinoma spreading along the common bile duct and in 3 other cases multiple smooth extrinsic impressions along the common bile duct; in one patient MRCP demonstrated an irregular narrowing of the common bile duct mimicking chronic cholangitis. In all cases, the bile duct varices appeared of low T2W signal; in three cases, fibrosis was identified on delayed sequences.RESULTSThree different types of biliary involvement were found: in 3 cases findings that mimic cholangiocarcinoma spreading along the common bile duct and in 3 other cases multiple smooth extrinsic impressions along the common bile duct; in one patient MRCP demonstrated an irregular narrowing of the common bile duct mimicking chronic cholangitis. In all cases, the bile duct varices appeared of low T2W signal; in three cases, fibrosis was identified on delayed sequences.MRCP and MR-angiography can be proposed as a first imaging study in patients with portal cavernoma and cholestasis or bile duct dilatation.CONCLUSIONMRCP and MR-angiography can be proposed as a first imaging study in patients with portal cavernoma and cholestasis or bile duct dilatation.