Feasibility of morphologic assessment of vascular and biliary anatomy in pediatric liver transplantation: all-in-one protocol with breath-hold magnetic resonance

Chu, Winnie Cw; Yeung, Deacons T.K.; Lee, Kim-Hung; Lam, William W. Y.; Yeung, Chung‐Kwong

doi:10.1016/j.jpedsurg.2005.06.024

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Its invasiveness, higher procedural risk, and failure rate, especially in pediatric patients, prompted the consideration of alternative modalities (7). Currently, multi‐detector CT and MRI are the modalities of choice in demonstrating anatomical structures (8, 9). The purpose of this study is to assess the usefulness and accuracy of CTA and MRA in evaluating vascular anomalies in BA patients undergoing LDLT.…”

mentioning

confidence: 99%

Preoperative imaging evaluation of the hepatic vasculature in biliary atresia patients undergoing LDLT: Comparison of MDCT and MRI

Yu¹,

Chen

Huang³

et al. 2009

Pediatric Transplantation

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LT is the definitive treatment option in the management of end-stage liver disease. Preoperative vascular evaluation plays an important role for a safe and successful operation in LDLT. The purpose of this study is to assess the usefulness and accuracy of CTA and MRA in evaluating vascular anomalies in BA patients undergoing LDLT. Images of CTA and MRA for preoperative vascular evaluation in 57 BA patients undergoing LDLT were reviewed with the operative and pathologic findings. All underwent preoperative CTA and MRA. Pathologic PV (n = 20), interruption of the retro-hepatic vena cava (n = 1), aberrant right HA from the SMA (n = 2) were confirmed during the transplant operation. The success rate of CTA and MRA in identifying vascular anomalies was 96% and 82%, respectively (p = 0.01). The IQR scores were 3.25 +/- 0.53 for CTA and 2.91 +/- 0.70 for MRA (p = 0.001). The sensitivity, specificity and accuracy of CTA were 85%, 97% and 93%, respectively; and for MRA, were 65%, 95% and 84%, respectively. CTA is superior than MRA in the preoperative evaluation of the vascular anatomy in pediatric BA LDLT candidates.

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mentioning

confidence: 99%

Preoperative imaging evaluation of the hepatic vasculature in biliary atresia patients undergoing LDLT: Comparison of MDCT and MRI

Yu¹,

Chen

Huang³

et al. 2009

Pediatric Transplantation

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“…mand for renal transplants has greatly increased, and approximately 17,000 kidney transplants were performed in 2006, although more than 75,000 people are still on the waiting list at the time of this writing (2).…”

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confidence: 99%

Kidney transplantation: Structural and functional evaluation using MR Nephro‐Urography

Kalb

Martín

Salman

et al. 2008

Magnetic Resonance Imaging

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End-stage-renal disease (ESRD) is a major health issue in the United States, and the Medicare costs of ESRD totaled nearly $21 billion in 2005. Renal transplantation has emerged as the treatment of choice in this patient population, providing improved quality of life and lower healthcare costs compared with other treatment options. Imaging evaluation of a graft kidney plays a critical role in the postoperative care of the renal transplant patient. In the past, diagnostic evaluation of the transplant kidney has depended upon a combination of ultrasonography, computed tomography, MRI, and biopsy, used in conjunction with the patient's clinical presentation. However, new and developing advances in MR technology has lead to the development of MR Nephro-Urography (MRNU), which provides both anatomic and functional evaluation of the kidney in a single examination. It is expected that the increasing use of MRNU will have a significant impact on the management of renal transplant patients. This review describes MRNU methodology, examines known posttransplant complications, and highlights the utility of MRNU as a comprehensive imaging examination to diagnose both surgical and medical complications of the transplant kidney.

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“…Because a decade ago, patients undergoing magnetic resonance angiography (MRA) were required to hold their breath and keep quiet for prolonged periods of time during the examination to obtain a clear image, these techniques were difficult to apply in pediatric patients, especially in infants and young children [31]. Recently, with the advent of high‐performance gradients, fast magnetic resonance scanning imaging protocols can now be performed with a single breath‐hold, even in pediatric patients after liver transplantation [32]. MRA has many advantages over CT angiography, such as noninvasiveness, the lack of a need for iodinated contrast agents, and multiplanar capability, which allows for imaging in coronal, sagittal, or other planes, we advocate the use of this modality for the follow‐up of pediatric liver transplant recipients [32,33] and converting CT to MRA for our periodic imaging examination is currently under consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, with the advent of high-performance gradients, fast magnetic resonance scanning imaging protocols can now be performed with a single breath-hold, even in pediatric patients after liver transplantation [32]. MRA has many advantages over CT angiography, such as noninvasiveness, the lack of a need for iodinated contrast agents, and multiplanar capability, which allows for imaging in coronal, sagittal, or other planes, we advocate the use of this modality for the follow-up of pediatric liver transplant recipients [32,33] and converting CT to MRA for our periodic imaging examination is currently under consideration.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of pediatric patients with late-onset portal vein stenosis after living donor liver transplantation

Kawano¹,

Mizuta²,

Sugawara³

et al. 2009

Transplant International

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Summary Portal vein stenosis (PVS) after living donor liver transplantation (LDLT) is a serious complication that can lead to graft failure. Few studies of the diagnosis and treatment of late‐onset (≥3 months after liver transplantation) PVS have been reported. One hundred thirty‐three pediatric (median age 7.6 years, range 1.3–26.8 years) LDLT recipients were studied. The patients were followed by Doppler ultrasound (every 3 months) and multidetector helical computed tomography (once a year). Twelve patients were diagnosed with late‐onset PVS 0.5–6.9 years after LDLT. All cases were successfully treated with balloon dilatation. Five cases required multiple treatments. Early diagnosis of late‐onset PVS and interventional radiology therapy treatment may prevent graft loss.

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Feasibility of morphologic assessment of vascular and biliary anatomy in pediatric liver transplantation: all-in-one protocol with breath-hold magnetic resonance

Cited by 8 publications

References 17 publications

Preoperative imaging evaluation of the hepatic vasculature in biliary atresia patients undergoing LDLT: Comparison of MDCT and MRI

Preoperative imaging evaluation of the hepatic vasculature in biliary atresia patients undergoing LDLT: Comparison of MDCT and MRI

Kidney transplantation: Structural and functional evaluation using MR Nephro‐Urography

Diagnosis and treatment of pediatric patients with late-onset portal vein stenosis after living donor liver transplantation

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