Meersschaut V, Mortelé K J, Troisi R, Van Vlierberghe H, De Vos M, Defreyne L, de Hemptinne B, Kunnen M
Department of Radiology, University Hospital Ghent, Belgium.
Eur Radiol. 2000;10(10):1576-81. doi: 10.1007/s003300000379.
The aim of this study was to describe the spectrum of abnormal biliary findings as seen with magnetic resonance cholangiography (MRC) in symptomatic patients after orthotopic liver transplantation (OLT). In our study we included 12 consecutive patients post-OLT who presented with clinical and/or biochemical suspicion of biliary complications. In all patients MRC was performed on a 1.0-T whole-body magnet and breathhold half-Fourier acquired single-shot turbo spin echo and rapid acquisition with relaxation enhancement sequences were used. Diagnostic confirmation was obtained with percutaneous transhepatic cholangiography (PTC; n = 3 patients), endoscopic retrograde cholangiography (ERC; n = 3 patients), or clinical follow-up. A vast array of biliary abnormalities were detected in 11 of 12 patients: high-grade, obstructive, anastomotic stricture was the most common unique abnormality. Findings consistent with bile duct necrosis, the second most common abnormality, were accompanied by arterial abnormalities in 2 of 5 patients on subsequent MR- and digital subtraction angiography. Compared with the findings obtained with direct cholangiography (n = 5 patients), MRC was highly accurate for the detection and characterization of postoperative biliary complications. Compared with the final diagnosis, which was based on PTC-ERC findings and/or all available clinical data, MRC imaging alone was able to provide a specific diagnosis in 9 of 12 patients. Magnetic resonance cholangiography is an accurate, time-saving, and non-invasive imaging modality in the evaluation of post-OLT patients in whom suspicion of biliary complications exists. Although the precise value of MRA in this patient group requires larger dedicated studies, single session "all-in-one" MR evaluation of both biliary and arterial system in our series proved to be a substantial benefit in obtaining an accurate and complete diagnosis.
本研究的目的是描述原位肝移植（OLT）术后有症状患者磁共振胆胰管造影（MRC）所见的异常胆道表现谱。在我们的研究中，纳入了12例连续的OLT术后患者，这些患者出现了临床和/或生化方面怀疑有胆道并发症的情况。所有患者均在1.0-T全身磁体上进行MRC检查，采用屏气半傅里叶采集单次激发快速自旋回波序列和快速采集弛豫增强序列。通过经皮经肝胆管造影（PTC；3例患者）、内镜逆行胆管造影（ERC；3例患者）或临床随访获得诊断证实。12例患者中有11例检测到大量胆道异常：高度、梗阻性吻合口狭窄是最常见的独特异常。胆管坏死是第二常见的异常表现，在随后的磁共振血管造影和数字减影血管造影中，5例患者中有2例伴有动脉异常。与直接胆管造影（5例患者）的结果相比，MRC对术后胆道并发症的检测和特征描述具有高度准确性。与基于PTC-ERC结果和/或所有可用临床数据的最终诊断相比，仅MRC成像就能在12例患者中的9例中提供明确诊断。磁共振胆胰管造影是评估存在胆道并发症怀疑的OLT术后患者的一种准确、省时且无创的成像方式。尽管MRA在该患者群体中的精确价值需要更大规模的专门研究，但在我们的系列研究中，对胆道和动脉系统进行单次“一体化”MR评估被证明在获得准确和完整诊断方面具有很大益处。
