title: Vascular complications after living related liver transplantation: evaluation with gadolinium-enhanced three-dimensional MR angiography.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the efficacy of gadolinium-enhanced three-dimensional (3D) MR angiography for detection of vascular complications in patients who have undergone living related liver transplantation.
  
  
  METHODS
  Seventy-six patients who underwent living related liver transplantation were evaluated with gadolinium-enhanced 3D MR angiography. All MR angiograms were assessed for patency of the hepatic artery and the portal vein using a four-point scale (grades I-IV). The results were correlated with conventional angiography (n = 23) and clinical follow-up with Doppler sonography (n = 53) for more than 6 months.
  
  
  RESULTS
  Seventy-three of 76 MR angiography procedures were technically adequate. When grades III (focal narrowing [> 50%] at the anastomotic site) and IV (abrupt cutoff at the anastomotic site with nonvisualization of the right [or left] hepatic artery distal to the anastomosis) were regarded as the diagnostic criteria for hepatic artery stenosis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MR angiography were 100%, 74%, 29%, 100%, and 77%, respectively. In the portal vein, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MR angiography were 100%, 84%, 35%, 100%, and 85%, respectively, when grades III (narrowing [> 50%] without poststenotic dilatation) and IV (narrowing [> 50%] with poststenotic dilatation) were defined as criteria for portal vein stenosis.
  
  
  CONCLUSIONS
  MR angiography was sensitive but not specific in the detection of significant vascular stenosis after living related liver transplantation. However, normal MR angiography findings reliably exclude the possibility of significant stenosis.
authors.affiliation: Department of Diagnostic Radiology, University of Ulsan, Asan Medical Center, 388-1 Poongnap-dong, Songpa-ku, Seoul, 138-736, Korea.
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Kim
authors.forename: Tae Kyoung
authors.initials: TK
authors.lastname: Kim
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Jung
authors.forename: Jung Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: In Young
authors.initials: IY
authors.lastname: Bae
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Pyo Nyun
authors.initials: PN
authors.lastname: Kim
authors.forename: Hyun Kwon
authors.initials: HK
authors.lastname: Ha
authors.forename: Sung Gyu
authors.initials: SG
authors.lastname: Lee
authors.forename: Moon-Gyu
authors.initials: MG
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D003251:Constriction, Pathologic; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA