MR cholangiography in orthotopic liver transplantation: sensitivity and specificity in detecting biliary complications.
BACKGROUND
To assess the diagnostic value of magnetic resonance cholangiography (MRC) when evaluating biliary complications in a large series of liver transplants.


METHODS
One hundred and twenty-nine patients prospectively underwent magnetic resonance (MR) imaging and MR cholangiography at 1.5-T device after orthotopic liver transplantation (OLT). After the preliminary acquisition of axial T1- and T2-weighted images, MRC involved respiratory-triggered, thin-slab (2 mm), heavily T2-weighted fast spin-echo and breath-hold, thick-slab (10-50 mm), single-shot T2-weighted sequences. MR images were blindly evaluated by two experienced readers in conference to determine the biliary anatomy and the presence of complications, whose final diagnosis was based on endoscopic retrograde cholangiography, percutaneous trans-hepatic cholangiography, and by integrating clinical follow-up with ultrasound and/or MR findings.


RESULTS
Biliary complications were found in 60 patients (46.5%) and were represented by ischemic-type biliary lesions (n=21); anastomotic strictures (n=13); non-anastomotic strictures (n=5); anastomotic strictures associated to lithiasis (n=6); lithiasis (n=6); papillary dysfunctions (n=9). The sensitivity, specificity, positive predictive value, and negative predictive value of the reviewers for the detection of all types of biliary complications in patients with OLT were 98%, 94%, 94%, and 98%, respectively.


CONCLUSIONS
MRC is a reliable technique for detecting post-OLT biliary complications and should be recommended before planning therapeutic interventions.
Boraschi
Piero
P
2nd Unit of Radiology, Department of Oncologic and Radiological Sciences, Pisa University Hospital, Pisa, Italy. p.boraschi@do.med.unipi.it
Donati
Francescamaria
F
Gigoni
Roberto
R
Volpi
Alessia
A
Salemi
Simonetta
S
Filipponi
Franco
F
Falaschi
Fabio
F
D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000209:etiology; D002758:Cholangiography; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult