Detection of biliary complications after orthotopic liver transplantation with MR cholangiography

Boraschi, Piero; Braccini, G; Gigoni, R; Sartoni, G.; Neri, Emanuele; Filipponi, Franco; Mosca, Franco; Bartolozzi, Carlo

doi:10.1016/s0730-725x(01)00443-x

Cited by 88 publications

(59 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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.…”

Section: Viewing Of the Bile Ductssupporting

confidence: 86%

“…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.…”

Section: Discussionmentioning

confidence: 54%

“…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 .…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Viewing Of the Bile Ductsmentioning

confidence: 99%

“…The application of cholangiopancreatography by means of magnetic resonance (CPMR) for diagnosing biliary complications following OLT began at the end of the 1990s, and there are still only a few reports on its utilization for this purpose [18][19][20][21][22][23] . The initial use of CPMR was accompanied by controversy regarding the capacity of this method for detecting stenosing lesions in bile ducts without significant dilatation.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

et al. 2010

View full text Add to dashboard Cite

Purpose: To evaluate the accuracy and reproducibility of magnetic resonance cholangiopancreatography (MRCP) in the detection of biliary complications in liver transplanted patients. Methods: A study was conducted, with blinded review of 28 MRCP exams of 24 patients submitted to liver transplantation. The images were reviewed by two independent observers, at two different moments, regarding the degree of biliary tree visualization and the presence or absence of biliary complications. The MRCP results were compared, when negative, to at least 3 months of clinical and biochemical follow-up, and when positive, to the findings at surgery or endoscopic retrograde cholangiopancreatography (ERCP). Results: The degree of intrahepatic biliary tree visualization was considered good or excellent in 78.6% and 82.1% of the exams by the two observers and visualization of the donor duct, recipient duct and biliary anastomosis was considered good or excellent in 100% of the exams, by both observers. Six biliary complications were detected (21.4%), all of them anastomotic strictures. Intra and interobserver agreement were substantial or almost perfect (kappa k values of 0.611 to 0.804) for the visualization of the biliary tree and almost perfect (k values of 0.900 to 1.000) for the detection of biliary complications. MRCP achieved 100% sensitivity, 95.45% specificity, 85.7% positive predictive value and 100% negative predictive value for the detection of biliary complications. Conclusions: MRCP is an accurate examination for the detection of biliary complications after orthotopic liver transplantation and it is a highly reproducible method in the evaluation of the biliary tree of liver transplanted patients. Key words: Liver Transplantation. Magnetic Resonance Imaging. Bile Ducts. Cholangiography. RESUMOObjetivo: Medir a acurácia e reprodutibilidade da colangiopancreatografia por ressonância magnética (CPRM) na avaliação da visibilização de complicações biliares em pacientes submetidos a transplantes hepáticos ortotópicos. Métodos: Realizado estudo retrospectivo de 28 exames de CPRM de 24 pacientes submetidos a transplantes hepáticos. Os exames foram interpretados por dois observadores independentes, em dois momentos distintos, quanto ao grau de visibilização das estruturas estudadas e quanto à presença ou ausência de alterações nas vias biliares. Os resultados da CPRM foram comparados, nos casos de CPRM negativa, à evolução clínico-laboratorial por pelo menos 3 meses e, nos casos de CPRM alterada, aos achados de colangiopancreatografia retrógrada endoscópica (CPRE) e cirurgia, quando indicados. Resultados: A visibilização das vias biliares intra-hepáticas foi considerada boa ou excelente em 78,6% e 82,1% dos exames pelos dois observadores. A visibilização da via biliar extra-hepática do doador e do receptor, bem como da anastomose biliar, foi considerada boa ou excelente em 100% dos casos por ambos os observadores. Foram detectadas seis complicações biliares (21,4% dos casos), todas elas estenoses anastomóticas. A conco...

show abstract