Accuracy of magnetic resonance cholangiography in the evaluation of late biliary complications after orthotopic liver transplantation.
BACKGROUND
The aim of our study was to evaluate the role of magnetic resonance cholangiography (MRC) in the diagnosis of late biliary complications after orthotopic liver transplantation (OLT) and to assess the diagnostic accuracy of this imaging technique.


METHODS
Seventy-one MRC were performed in 46 OLT patients with suspected biliary complication after T-tube removal. We used a fat-suppressed three-dimensional turbo spin-echo sequence (TR/TE 1800/700, ETL 100) with a 1.5-T magnet. The images and maximum intensity projections were evaluated by two radiologists. Diagnostic confirmation was obtained with percutaneous transhepatic cholangiography (PTC) (n = 10), endoscopic retrograde cholangiography (ERC) (n = 24), surgery (n = 5), and clinical and ultrasound follow-up (n = 30).


RESULTS
The MRC studies were considered diagnostic by the two radiologists in 69 cases (97.2%). MRC had a sensitivity of 93%, a specificity of 97.6%, a positive predictive value of 96.3%, a negative predictive value of 95.2%, and a global diagnostic accuracy of 95.6% to detect late biliary complications in OLT patients. The interobserver agreement was excellent (kappa = .92).


CONCLUSIONS
MRC is a reliable technique to detect and exclude late biliary complications after OLT.
Beltrán
M Muñoz
MM
Department of Radiology, Ramón y Cajal Hospital, Madrid, Spain. mariamb@movistar.com
Marugán
R Bárcena
RB
Oton
E
E
Blesa
C
C
Nuño
J
J
D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D001652:Bile Ducts / Q000601:surgery; D002758:Cholangiography / Q000379:methods*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015203:Reproducibility of Results