title: Evaluation of biliary complications on magnetic resonance cholangiopancreatography and comparison with direct cholangiography after living-donor liver transplantation.
abstract: OBJECTIVE
  To evaluate the imaging characteristics of biliary complications following liver transplantation on magnetic resonance cholangiopancreatography (MRCP) and its diagnostic accuracy in comparison with direct cholangiography.
  
  
  METHODS
  In this prospective study, 34 patients being evaluated for possible biliary complications after living-donor liver transplantation (LDLT) with abnormal MRCP findings were followed up for information regarding direct cholangiography either endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) within 7 days of MRCP. Twenty-nine patients underwent ERCP and five patients underwent PTC.
  
  
  RESULTS
  Compared to findings at direct cholangiography, MRCP presented 96.9% sensitivity, 96.9% positive predictive value, and 94.1% accuracy for the detection of biliary complications. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection of anastomotic strictures, biliary leak, and biliary stone or sludge on MRCP was found to be 100%, 84.6%, 91.3%, 100% and 94.1%; 72.7%, 95.7%, 88.9%, 88% and 88.2%; 80%, 100%, 100%, 96.7% and 97.1%, respectively.
  
  
  CONCLUSIONS
  MRCP is a reliable non-invasive technique to evaluate the biliary complications following LDLT. MRCP should be the imaging method of choice for diagnosis in this setting and direct cholangiography should be reserved for cases that need therapeutic interventions.
authors.affiliation: Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India.
authors.forename: B
authors.initials: B
authors.lastname: Garg
authors.affiliation: Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India. Electronic address: drruchirastogi@yahoo.com.
authors.forename: R
authors.initials: R
authors.lastname: Rastogi
authors.affiliation: Department of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Indraprastha Apollo Hospital, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India.
authors.forename: H
authors.initials: H
authors.lastname: Rastogi
authors.affiliation: Department of Hepatology and Gastroenterology, Centre for Liver & Biliary Sciences, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India.
authors.forename: H
authors.initials: H
authors.lastname: Garg
authors.affiliation: Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India.
authors.forename: V
authors.initials: V
authors.lastname: Chowdhury
mesh_terms: D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging*; D002758:Cholangiography; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D055815:Young Adult