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. 2022 Jan;47(1):48-52.
doi: 10.30476/IJMS.2021.88447.1918.

Anatomic Variations of the Cystic Duct in Magnetic Resonance Cholangiopancreatography in Shiraz: A Cross-Sectional Study

Alireza Taghavi  1 , Masoud Azizi  1 , Alireza Rasekhi  2 , Zeinab Gholami  2
Affiliations

Anatomic Variations of the Cystic Duct in Magnetic Resonance Cholangiopancreatography in Shiraz: A Cross-Sectional Study

Alireza Taghavi et al. Iran J Med Sci. 2022 Jan.

Abstract

Background: Anatomic variations of the cystic duct (CD) are commonly encountered. Being aware of these variants will reduce complications subsequent to surgical, endoscopic, or percutaneous procedures. Magnetic resonance cholangiopancreatography (MRCP) is the least invasive and the most reliable modality for biliary anatomy surveys. This study aimed to determine the prevalence of cystic duct variations in the Iranian population.

Methods: In this retrospective cross-sectional study, MRCP images of 350 patients referred to Shiraz Faraparto Medical Imaging and Interventional Radiology Center from October 2017 to October 2018 were reviewed. The CD course and insertion site to the extrahepatic bile duct (EHBD) was determined and documented in 290 cases. Descriptive statistics and Chi square test were applied for data analysis via SPSS software.

Results: About 77% of cases revealed the classic right lateral insertion to the middle third of EHBD. The insertion of CD to the upper third and the right hepatic duct was 10%, and the insertion to the medial aspect of the middle third of EHBD from anterior or posterior was noted to be about 7.6%. From 2.8% of insertions to the lower third, 1% demonstrated parallel course, and finally, 0.3% of cases presented short CD.

Conclusion: CD variations are relatively common, and MRCP mapping prior to the hepatobiliary interventions could prevent unexpected consequences.

Keywords: Bile ducts; Cholangiopancreatography; Cystic duct; Extrahepatic; Magnetic resonance; Radiography.

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Figures

Figure 1
Figure 1
Coronal maximum intensity projection (MIP) reformat illustrates normal lateral insertion of cystic duct to the lateral aspect of the extrahepatic bile duct (EHBD) (arrow)
Figure 2
Figure 2
Coronal maximum intensity projection (MIP) reformat shows a high insertion of cystic duct to proximal extrahepatic bile duct (EHBD) (arrow).
Figure 3
Figure 3
Coronal maximum intensity projection (MIP) reformat shows a high insertion of cystic duct to the right hepatic duct (RHD) (arrow).
Figure 4
Figure 4
Coronal maximum intensity projection (MIP) reformat reveals a medial spiral insertion to the mid part of the extrahepatic bile duct (EHBD) (arrow).
See this image and copyright information in PMC

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