Accuracy of magnetic resonance cholangiography in the evaluation of late biliary complications after orthotopic liver transplantation

Abstract

Introduction: The aim of our study was to evaluate the role of magnetic resonance cholangiography (MRC) in the diagnosis of late biliary complications after orthotopic liver transplantation (OLT) and to assess the diagnostic accuracy of this imaging technique.

Materials and methods: Seventy-one MRC were performed in 46 OLT patients with suspected biliary complication after T-tube removal. We used a fat-suppressed three-dimensional turbo spin-echo sequence (TR/TE 1800/700, ETL 100) with a 1.5-T magnet. The images and maximum intensity projections were evaluated by two radiologists. Diagnostic confirmation was obtained with percutaneous transhepatic cholangiography (PTC) (n = 10), endoscopic retrograde cholangiography (ERC) (n = 24), surgery (n = 5), and clinical and ultrasound follow-up (n = 30).

Results: The MRC studies were considered diagnostic by the two radiologists in 69 cases (97.2%). MRC had a sensitivity of 93%, a specificity of 97.6%, a positive predictive value of 96.3%, a negative predictive value of 95.2%, and a global diagnostic accuracy of 95.6% to detect late biliary complications in OLT patients. The interobserver agreement was excellent (kappa = .92).

Conclusion: MRC is a reliable technique to detect and exclude late biliary complications after OLT.