MR cholangiography of late biliary complications after liver transplantation

OBJECTIVE. The aim of our study was to assess the role of MR cholangiograph y in the diagnosis of late biliary complications after liver transplantatio n. SUBJECTS AND METHODS. Twenty-three liver transplantation patients (18 men a nd five women; mean age, 46 years) underwent MR cholangiography using a non breath-hold, fat-suppressed three-dimensional turbo spin-echo sequence (TR/ TE, 3000/700; echo train length, 128) optimized on a 0.5-T magnet. Inclusio n criteria were liver function tests with abnormal results and hyperbilirub inemia with a clinical pattern not specific for biliary obstruction. All pa tients were referred by clinicians for contrast-enhanced cholangiography. D iagnostic confirmation was obtained with percutaneous transhepatic cholangi ography (n = 4), endoscopic retrograde cholangiography (n = 8), T-tube chol angiography (n = 1), or clinical follow-up (n = 10). RESULTS. In 11 patients, no abnormalities of the biliary tract were reveale d by MR cholangiography. In 11 patients, twelve strictures were diagnosed ( nine anastomotic, two nonanastomotic-intrahepatic, and one nonanastomotic-e xtrahepatic, with association between anastomotic and nonanastomotic strict ures in two cases). In one other patient, kinking of the common bile duct a t the level of the anastomosis was observed. In all cases, MR cholangiograp hy correctly showed the sire of the stricture and the dilatation of bile du cts above, with excellent correlation with contrast-enhanced cholangiograph ic findings. Strictures were correctly graded in eight of 10 patients and w ere overestimated in two. Other findings included a 1-cm stone detected pro ximal to the obstructed common bile duct in one patient and multiple intrah epatic stones in another patient. CONCLUSION. MR cholangiography can show biliary obstruction and provide imp ortant information for planning therapeutic procedures.