Magnetic resonance cholangiography in the diagnosis of biliary complications after orthotopic liver transplantation.
OBJECTIVE
The aim of our study was to evaluate the role of magnetic resonance cholangiography (MRC) in the diagnosis of biliary tract complications (BC) after orthotopic liver transplantation (OLT).


METHODS
Among 21 OLT patients who underwent routine follow-up MRC using a breath-hold T2-weighted turbo spin-echo sequence with half-Fourier acquisition (HASTE), 5 had an elevated serum alkaline phosphatase level. Diagnostic confirmation was obtained with endoscopic retrograde cholangiography (ERC) (n = 11), surgery (n = 3), or clinical and laboratory follow-up of at least 1 year (n = 8).


RESULTS
In 13 patients, no abnormality of the biliary tract was detected using MRC. In 8 patients, anastomotic strictures were diagnosed, 7 of which were confirmed at surgery or using ERC. One patient with normal findings at MRC and abnormal liver function test results was found to have a stricture at ERC. All patients with normal MRC and liver function tests had 1 year of uneventful follow-up and were considered true-negative cases. We found that MRC had 87.5% sensitivity, 92.3% specificity, 87.5% positive predictive value, 92.3% negative predictive value, and 90.4% accuracy for the diagnosis of BC.


CONCLUSIONS
MRC is a valuable examination to detect BC after OLT. It provides useful information for planning interventional procedures.
Linhares
M M
MM
São Paulo Federal University Medical School, Federal University of São Paulo, Sao Paulo, Brazil. marbet@uol.com.br
Gonzalez
A M
AM
Goldman
S M
SM
Coelho
R D S
RD
Sato
N Y
NY
Moura
R M A M
RM
Silva
M H G
MH
Lanzoni
V P
VP
Salzedas
A
A
Serra
C B
CB
Succi
T
T
D'Ippolito
G
G
Szejnfeld
J
J
Triviño
T
T
D002758:Cholangiography; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D018810:Magnetic Resonance Angiography; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies