title: Clinical value of MRC in the follow-up of liver transplant patients with a choledochojejunostomy.
abstract: BACKGROUND
  We investigated the clinical value of magnetic resonance cholangiography (MRC) in liver transplant patients receiving choledochojejunostomy (CDJ).
  
  
  METHODS
  Twenty-five MRCs were performed in 23 initially asymptomatic patients 19 months (mean) after liver transplantation with biliary reconstruction via CDJ. The images were evaluated by consensus (two investigators) for bile duct strictures and dilatations. As a standard of reference, clinical follow-up (including laboratory analysis) was used in 20 cases and direct cholangiography or surgery in three cases.
  
  
  RESULTS
  Fourteen pathologic findings were observed in 11 patients (anastomotic strictures in four, left or right bile duct strictures in three, and peripheral segmental dilatations with or without strictures in seven). Patients with pathologic MRC findings had significantly higher levels of alkaline phosphatase (p < 0.05) and more frequently had histories of cholangitis than did patients with normal MRC. Four of six patients with stenoses of the central bile ducts subsequently developed biliary complications requiring treatment (three confirmed by direct cholangiography). In patients with unremarkable bile ducts or only peripherally located changes on MRC, no bile duct complications or relevant changes in the cholestasis parameters occurred during follow-up (mean = 30 months).
  
  
  CONCLUSIONS
  MRC can noninvasively detect pathologic biliary tract changes in liver transplant patients in the asymptomatic stage and provide information for planning invasive therapeutic procedures.
authors.affiliation: Department of Surgery, University of Erlangen-Nuremberg, Krankenhausstr. 12, D-91054 Erlangen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Ott
authors.forename: H
authors.initials: H
authors.lastname: Greess
authors.forename: U
authors.initials: U
authors.lastname: Aichinger
authors.forename: F
authors.initials: F
authors.lastname: Fellner
authors.forename: C
authors.initials: C
authors.lastname: Herold
authors.forename: S
authors.initials: S
authors.lastname: Yedibela
authors.forename: M
authors.initials: M
authors.lastname: Bussenius-Kammerer
authors.forename: V
authors.initials: V
authors.lastname: Müller
authors.forename: W
authors.initials: W
authors.lastname: Hohenberger
authors.forename: T
authors.initials: T
authors.lastname: Reck
mesh_terms: D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000473:pathology*; D002758:Cholangiography; D002761:Cholangitis / Q000000981:diagnostic imaging* / Q000473:pathology*; D002768:Choledochostomy; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests