Vascular complications after living related liver transplantation: evaluation with gadolinium-enhanced three-dimensional MR angiography.
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.
Kim
Bong Soo
BS
Department of Diagnostic Radiology, University of Ulsan, Asan Medical Center, 388-1 Poongnap-dong, Songpa-ku, Seoul, 138-736, Korea.
Kim
Tae Kyoung
TK
Jung
Dong Jin
DJ
Kim
Jung Hoon
JH
Bae
In Young
IY
Sung
Kyu-Bo
KB
Kim
Pyo Nyun
PN
Ha
Hyun Kwon
HK
Lee
Sung Gyu
SG
Lee
Moon-Gyu
MG
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
D003287:Contrast Media; D019786:Gadolinium DTPA