Detection of biliary complications after orthotopic liver transplantation with MR cholangiography

To assess the diagnostic value of magnetic resonance cholangiography (MRC) when evaluating biliary complications in the follow-up of liver transplant patients. One hundred and thirteen patients prospectively underwent MR imag ing and MR cholangiography at 1.5-T unit after orthotopic liver transplanta tion (OLT). After the acquisition of axial T1- and T2-weighted sequences, M RC involved a coronal, non breath-hold, respiratory-triggered, fat-suppress ed, two-dimensional, thin-slab, heavily T2-weighted fast spin-echo sequence , and coronal breath-hold, thick-slab, single-shot T2-weighted sequences. T he images and maximum intensity projections were evaluated by two readers i n order to determine biliary anatomy and the presence of complications, who se final: diagnosis was based on endoscopic retrograde cholangiography (ERC ) in 50 patients, percutaneous trans-hepatic cholangiography (PTC) in five, and by integrating clinical follow-up with ultrasound and MR findings in 5 8 cases. MRC had a sensitivity of 93%, a specificity of 92%, a positive pre dictive value of 86%, a negative predictive value of 96%, and a global diag nostic accuracy of 93% in detecting all types of biliary complications, in OLT patients. MRC is a reliable technique for detecting post-OLT biliary co mplications. We now restrict the use of ERC to patients for whom therapeuti c procedures are advocated or whose MRC results are equivocal (C) 2001 Else vier Science Inc. All rights reserved.