Ogul Hayri, Kantarci Mecit, Pirimoglu Berhan, Karaca Leyla, Aydinli Bulent, Okur Aylin, Ozturk Gurkan, Kizrak Yesim
Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey.
Clin Transplant. 2014 Mar;28(3):354-60. doi: 10.1111/ctr.12320. Epub 2014 Feb 8.
The aim of this study was to evaluate utility of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) for the detection of biliary complications after living donor liver transplantation (LDLT). A total of 18 patients with suspected biliary complications underwent MRC. T2-weighted MRC and contrast-enhanced MRC (CE-MRC) were used to identify the biliary complications. MRC included routine breath-hold T2-weighted MRC using half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences and Gd-EOB-DTPA-enhanced MRC T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences. Before confirming the biliary complications, one observer reviewed the MRC images and the CE-MRC images separately. The verification procedures and MRC findings were compared, and the sensitivity, specificity, and accuracy of both techniques were calculated for the identification of biliary complications. The observer found six of seven biliary complications using CE-MRC. The sensitivity was 85.7% and the accuracy was 94.4%. Using MRC alone, sensitivity was 57.1% and accuracy was 55.5%. The accuracy of Gd-EOB-DTPA-enhanced MRC was superior to MRC in locating biliary leaks (p < 0.05). The usage of Gd-EOB-DTPA-enhanced MRC yields information that complements the MRC findings that improve the identification of biliary complications. We recommend the use of MRC in addition to Gd-EOB-DTPA-enhanced MRC to increase the preoperative accuracy when assessing the biliary complications after LDLT.
本研究的目的是评估钆塞酸二钠(Gd-EOB-DTPA)增强磁共振胆胰管造影(MRC)在活体肝移植(LDLT)后胆道并发症检测中的应用价值。共有18例疑似胆道并发症的患者接受了MRC检查。采用T2加权MRC和对比增强MRC(CE-MRC)来识别胆道并发症。MRC包括使用半傅里叶采集单次激发快速自旋回波(HASTE)序列的常规屏气T2加权MRC和Gd-EOB-DTPA增强MRC T1加权容积内插屏气检查(VIBE)序列。在确认胆道并发症之前,一名观察者分别回顾了MRC图像和CE-MRC图像。比较了验证程序和MRC结果,并计算了两种技术在识别胆道并发症方面的敏感性、特异性和准确性。观察者使用CE-MRC发现了7例胆道并发症中的6例。敏感性为85.7%,准确性为94.4%。单独使用MRC时,敏感性为57.1%,准确性为55.5%。Gd-EOB-DTPA增强MRC在定位胆漏方面的准确性优于MRC(p<0.05)。使用Gd-EOB-DTPA增强MRC可提供补充MRC结果的信息,从而改善对胆道并发症的识别。我们建议在评估LDLT后胆道并发症时,除了使用Gd-EOB-DTPA增强MRC外,还应使用MRC,以提高术前准确性。