The role of MR cholangiography in the detection of biliary complications after orthotopic liver transplantation

Background: To assess the usefulness of magnetic resonance cholangiography (MRC) in the diagnostics of biliary complications after liver transplantation. Material/Methods: In 40 patients (17 men, 23 women) 51 MRC examinations were performed, from 1 to 58 months (mean-12) after liver transplantation. Studies were performed with 1.5 T unit. The imaging protocol consisted of tree hydrographic TSE sequences: 2D, 3D and single-slice technique. The results were compared with ERCP (n=10), percutaneous cholangiography (n=4), T-tube cholangiography (n=1), T-tube cholangiography and percutaneous cholangiography (n=1), T-tube cholangiography and ERCP (n=1), fistulography (n=2) and histopathology (n=3). In remaining patients other imaging studies (US, CT), laboratory liver functions tests and clinical status were evaluated. Results: In 46 cases (90%) abnormalities of biliary tract were depicted. Following biliary complications were diagnosed: dilatation of biliary tree (n=29), biliary strictures located beside anastomosis site (n=19), anastomotic biliary strictures (n=17), intrahepatic strictures (n=7), biliary obstruction (n=2), biliary stones/sludge (n=14), bile leak (n=12). In 5 cases (10%) MRC was normal. In 50 cases (98%) there was concordance between MRC results and the standard of reference, 1 remaining case (2%) of bile duct ischemia was not confirmed by other studies. Conclusions: MRC is a noninvasive modality, providing accurate assessment of biliary complications in patients after liver transplantation.