Laghi A, Pavone P, Catalano C, Rossi M, Panebianco V, Alfani D, Passariello R. MR cholangiography of late biliary complications after liver transplantation. AJR Am J Roentgenol 1999 Jun;172(6):1541-6 Department of Radiology, University of Rome La Sapienza, Policlinico Umberto I, Italy.
OBJECTIVE: The aim of
our study was to assess the role of MR cholangiography in the
diagnosis of late biliary complications after liver transplantation.
SUBJECTS AND METHODS: Twenty-three liver transplantation patients
(18 men and five women; mean age, 46 years) underwent MR cholangiography
using a nonbreath-hold, fat-suppressed three-dimensional turbo
spin-echo sequence (TR/TE, 3000/700; echo train length, 128) optimized
on a 0.5-T magnet. Inclusion criteria were liver function tests
with abnormal results and hyperbilirubinemia with a clinical pattern
not specific for biliary obstruction. All patients were referred
by clinicians for contrast-enhanced cholangiography. Diagnostic
confirmation was obtained with percutaneous transhepatic cholangiography
(n = 4), endoscopic retrograde cholangiography (n = 8), T-tube
cholangiography (n = 1), or clinical follow-up (n = 10). RESULTS:
In 11 patients, no abnormalities of the biliary tract were revealed
by MR cholangiography. In 11 patients, twelve strictures were
diagnosed (nine anastomotic, two nonanastomotic-intrahepatic,
and one nonanastomotic-extrahepatic, with association between
anastomotic and nonanastomotic strictures in two cases). In one
other patient, kinking of the common bile duct at the level of
the anastomosis was observed. In all cases, MR cholangiography
correctly showed the site of the stricture and the dilatation
of bile ducts above, with excellent correlation with contrast-enhanced
cholangiographic findings. Strictures were correctly graded in
eight of 10 patients and were overestimated in two. Other findings
included a 1-cm stone detected proximal to the obstructed common
bile duct in one patient and multiple intrahepatic stones in another
patient. CONCLUSION: MR cholangiography can show biliary obstruction
and provide important information for planning therapeutic procedures.
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