Biliary Complications After Liver Transplantation: Diagnosis with MR Cholangiopancreatography

Abstract

MRCP is a useful imaging procedure in the assessment of biliary complications after OLT.

Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation

“…This high frequency of good viewing was expected and was in agreement with the results from other authors 18,26 , and this reflects the capacity of present-day magnetic resonance apparatus to produce bile duct images of trustworthy diagnostic quality. We adopted the practice of informing the observer regarding the type of bile duct anastomosis that had been used, since the lack of this information could lead to errors in interpreting the findings (such that, in cases of biliodigestive derivation, the remaining part of the receiver duct could be interpreted as the distal bile duct associated with apparent anastomotic stenosis).…”

“…It was found only one case with abnormalities seen on CPMR that was not subsequently confirmed. This was a diagnosis of anastomotic stenosis seen on CPMR that was not confirmed by ERCP, thus giving the method specificity of 95.45%, which is compatible with other studies in the literature [18][19][20]23,26 . After analyzing the images from this case, we had the impression that the observers overvalued the "hour glass" appearance that is sometimes present at the anastomosis location.…”

“…The high sensitivity obtained by CPMR (100%) is backed up in other publications [18][19][20]23,26 . This result may be related to the absence of patients at the earliest postoperative stage, thus excluding bile extravasation from the complications.…”

“…Based on this need for a noninvasive examination method with high sensitivity and good availability, and together with the technological development of magnetic resonance equipment, CPMR emerged in the second half of the 1990s as an alternative for diagnosing biliary complication following OLT [18][19][20][21][22][23]26 .…”

“…Likewise, in the cases that were seen to be negative on CPMR, the absence of clinical and laboratory abnormalities was seen to be maintained for at least the next three months, or other conditions were diagnosed that would satisfactorily explain the abnormality seen on laboratory tests, and this allowed secure confirmation of the absence of bile duct abnormalities. This criterion for confirming negative cases was used in several of the more recent studies 19,20,23,26 , because of the tendency not to use bile drains, which makes cholangiographic access difficult.…”