Vascular and extravascular complications of liver transplantation: Comprehensive evaluation with three-dimensional contrast-enhanced volumetric MR imaging and MR cholangiopancreatography

OBJECTIVE. Our purpose was to evaluate a comprehensive MR imaging strategy for recipients of liver transplants that relies on dynamic interpolated thr ee-dimensional (3D) MR imaging for simultaneous vascular, parenchymal, and extrahepatic imaging, MATERIALS AND METHODS. Twenty-three consecutive adult patients underwent 30 MR imaging examinations between 2 days and 99 months (mean, 15 months) aft er transplantation using a breath-hold 3D gradient-echo sequence (TR range/ TE range, 3.7-4.7/1.8-1.9: flip angle, 12-30 degrees) with an intermittent fat-saturation pulse and interpolation in the section-select direction to e nable pixel size 3 rom or less in all dimensions. Unenhanced and triphasic contrast-enhanced 3D imaging (average dose, 0.13 mmol/kg, of gadopentetate dimeglumine) was performed. A subset of patients (n = 13) also underwent MR cholangiopancreatography using half-Fourier single-shot turbo spin-echo im aging. MR imaging examinations were correlated with digital subtraction ang iography (n = 8), contrast-enhanced cholangiography (n 9), sonography (n = 13), and histopathology (n = 14). RESULTS. MR imaging revealed abnormal findings in 27 (90%) of 30 examinatio ns, including vascular disease in nine, biliary complications in four, and evidence of intra- or extrahepatic hepatocellular carcinoma recurrence in s ix. Digital subtraction angiography confirmed seven MR. angiography examina tions but suggested disease overestimation in one. Contrast-enhanced cholan giography confirmed findings of MR cholangiopancreatography in seven cases but suggested disease underestimation in two. CONCLUSION. Dynamic interpolated 3D MR imaging combined with dedicated MR c holangiopancreatography can provide a comprehensive assessment of vascular, biliary, parenchymal, and extrahepatic complications in most recipients of liver transplants.