Magnetic resonance cholangiography of biliary strictures after liver transplantation: a prospective double-blind study.
OBJECTIVE
To compare magnetic resonance cholangiography (MRC) with endoscopic retrograde cholangiography (ERC) in quantitatively evaluating biliary strictures in liver transplant recipients.


METHODS
Eight liver transplant recipients with suspected biliary complications were referred for ERC and also underwent MRC within 24 hours using a combination of single-shot rapid acquisition with relaxation enhancement (SS-RARE) and three-dimensional (3D)-RARE sequences. The studies were independently interpreted by two blinded radiologists and a single blinded endoscopist who recorded the presence of a stricture and/or upstream dilatation, the ratio of recipient-to-donor duct diameters at the anastomosis, as well as the proximal duct diameter, length, and percent stenosis of any stricture detected.


RESULTS
Using ERC as the standard of reference, MRC had a sensitivity and negative predictive value of 100%, mean specificity of 83.3%, and mean positive predictive value of 92.9% in the detection of six strictures. Compared with ERC, MRC obtained accurate measurements of recipient-to-donor duct diameter ratios (r, 0.91; P < 0.01), proximal duct diameters (r, 0.83, P < 0.05), stricture lengths (r, 0.58; P = 0.06), and percent stenosis (r, 0.78; P = 0.06).


CONCLUSIONS
MRC can provide equivalent imaging to ERC and can reliably identify and quantitatively evaluate biliary strictures in post-orthotopic liver transplantation (OLT) patients.
Kitazono
Mary T
MT
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Qayyum
Aliya
A
Yeh
Benjamin M
BM
Chard
Paul S
PS
Ostroff
James W
JW
Coakley
Fergus V
FV
D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies