A Pecchi1, M De Santis, F Di Benedetto, M Gibertini, G Gerunda, P Torricelli. 1. Dipartimento Integrato dei Servizi Diagnostici e per Immagine, Università degli Studi di Modena e Reggio Emilia, Policlinico via del Pozzo 71, 41100 Modena, Italy. Anna_pecchi@libero.it
Abstract
PURPOSE: The aim of this study was to evaluate the role of magnetic resonance cholangiography (MRC) in the detection of biliary complications following orthotopic liver transplantation (OLT). MATERIALS AND METHODS: Seventy-eight transplant patients with clinically suspected biliary complications were evaluated with 1.5-T magnetic resonance imaging (MRI) using a surface coil. All patients were imaged with the following sequences: axial T1-weighted and axial and coronal T2-weighted, 2D spin echo (SE) breath-hold radial cholangiography, and coronal 3D single-shot turbo spin echo (SS-TSE) with respiratory triggering. Patients with negative MRI underwent clinical and sonographic followup. When biliary complications were present, diagnostic confirmation was obtained by endoscopic retrograde cholangiopancreatography (ERCP) (n=13), percutaneous transhepatic cholangiography (PTC) (n=20), ultrasonography (n=10) or computed tomography (CT) (n=2). In 11 cases, surgical confirmation was also obtained. RESULTS: MRC detected biliary complications in 44/78 patients, in particular, 42 biliary strictures (37 anastomotic and five intrahepatic), 40 of which were confirmed by other imaging modalities. In 25/37 cases of anastomotic stricture, preanastomotic dilatation of the biliary tract was also demonstrated. Other MRC-detected biliary complications were biliary sludge (n=4), biloma (n=5), and biliary stones (n=3). In four cases, PTC revealed biliary complications that had not been detected with MRC (false negative results). In two cases, MRC showed unconfirmed strictures of the intrahepatic ducts and biliodigestive anastomosis (false positive results). The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and diagnostic accuracy of MRC were 93.5%, 94.4%, 96.7%, 89.5% and 93.9%, respectively. CONCLUSIONS: Our results confirm that MRC is a reliable technique for depicting biliary anastomoses and detecting biliary complications after OLT. The high diagnostic accuracy of MRC indicates that this examination should be routinely employed in all OLT patients with clinically suspected biliary complications.
PURPOSE: The aim of this study was to evaluate the role of magnetic resonance cholangiography (MRC) in the detection of biliary complications following orthotopic liver transplantation (OLT). MATERIALS AND METHODS: Seventy-eight transplant patients with clinically suspected biliary complications were evaluated with 1.5-T magnetic resonance imaging (MRI) using a surface coil. All patients were imaged with the following sequences: axial T1-weighted and axial and coronal T2-weighted, 2D spin echo (SE) breath-hold radial cholangiography, and coronal 3D single-shot turbo spin echo (SS-TSE) with respiratory triggering. Patients with negative MRI underwent clinical and sonographic followup. When biliary complications were present, diagnostic confirmation was obtained by endoscopic retrograde cholangiopancreatography (ERCP) (n=13), percutaneous transhepatic cholangiography (PTC) (n=20), ultrasonography (n=10) or computed tomography (CT) (n=2). In 11 cases, surgical confirmation was also obtained. RESULTS: MRC detected biliary complications in 44/78 patients, in particular, 42 biliary strictures (37 anastomotic and five intrahepatic), 40 of which were confirmed by other imaging modalities. In 25/37 cases of anastomotic stricture, preanastomotic dilatation of the biliary tract was also demonstrated. Other MRC-detected biliary complications were biliary sludge (n=4), biloma (n=5), and biliary stones (n=3). In four cases, PTC revealed biliary complications that had not been detected with MRC (false negative results). In two cases, MRC showed unconfirmed strictures of the intrahepatic ducts and biliodigestive anastomosis (false positive results). The sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and diagnostic accuracy of MRC were 93.5%, 94.4%, 96.7%, 89.5% and 93.9%, respectively. CONCLUSIONS: Our results confirm that MRC is a reliable technique for depicting biliary anastomoses and detecting biliary complications after OLT. The high diagnostic accuracy of MRC indicates that this examination should be routinely employed in all OLT patients with clinically suspected biliary complications.
Authors: Q Hernandez; P Ramirez; V Munitiz; A Piñero; R Robles; F Sanchez-Bueno; J M Rodriguez; J Lujan; F Acosta; M Miras; J A Pons; P Parrilla Journal: Transplant Proc Date: 1999-09 Impact factor: 1.066
Authors: Rungsun Rerknimitr; Stuart Sherman; Evan L Fogel; Cem Kalayci; Lawrence Lumeng; Naga Chalasani; Paul Kwo; Glen A Lehman Journal: Gastrointest Endosc Date: 2002-02 Impact factor: 9.427
Authors: Sanjeet Thethy; Benjamin Nj Thomson; Henry Pleass; Stephen J Wigmore; Krishnakumar Madhavan; Murat Akyol; John Lr Forsythe; O James Garden Journal: Clin Transplant Date: 2004-12 Impact factor: 2.863
Authors: M M Linhares; A M Gonzalez; S M Goldman; R D S Coelho; N Y Sato; R M A M Moura; M H G Silva; V P Lanzoni; A Salzedas; C B Serra; T Succi; G D'Ippolito; J Szejnfeld; T Triviño Journal: Transplant Proc Date: 2004-05 Impact factor: 1.066
Authors: R Girometti; C Molinari; M Del Pin; P Toniutto; D Bitetto; G Como; C Zuiani; M Bazzocchi Journal: Radiol Med Date: 2012-03-19 Impact factor: 3.469