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Biliary complications following orthotopic liver transplantation: May contrast-enhanced MR Cholangiography provide additional information?  Piero Boraschi,

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Presentation on theme: "Biliary complications following orthotopic liver transplantation: May contrast-enhanced MR Cholangiography provide additional information?  Piero Boraschi,"— Presentation transcript:

1 Biliary complications following orthotopic liver transplantation: May contrast-enhanced MR Cholangiography provide additional information?  Piero Boraschi, Francescamaria Donati, Roberto Gigoni, Franco Filipponi  European Journal of Radiology Open  Volume 3, Pages (January 2016) DOI: /j.ejro Copyright © 2016 The Author(s) Terms and Conditions

2 Fig. 1 (A–D) 52-year-old man with progressive jaundice. Conventional coronal thick-slab single-shot MRC (A) and MIP reconstructions from 3D-T2-weighted images (B) do not visualize the confluence of the hepatic ducts and the common hepatic duct of the graft; slight dilation of the intrahepatic biliary system is well evident. MIP reconstructions obtained from MnDPDP-enhanced 3D T1-weighted MRC (C) better delineate narrowed and irregular donor’s extrahepatic biliary tract, in particular at the level of the right (white arrow) and the common (red arrow) hepatic ducts. Findings of typical ITBL were confirmed at ERC (D) and treated with a biliary stent. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.). European Journal of Radiology Open 2016 3, DOI: ( /j.ejro ) Copyright © 2016 The Author(s) Terms and Conditions

3 Fig. 2 (A–D) 44-year-old man with biochemical parameters of cholestasis. Conventional coronal thick-slab single-shot MRC (A) and MIP reconstructions from 3D T2-weighted images (B) show dilation of donor’s biliary tree; long discontinuity is suggested at anastomotic site. MIP reconstructions obtained from Mn-DPDP-enhanced 3D T1-weighted MRC (C) well exhibit the length and degree of anastomotic stricture (white arrow). ERC (D), obtained in the same patient, confirms the presence of a biliary stricture at the anastomotic site; stricture was endoscopically treated and a biliary stent was placed. European Journal of Radiology Open 2016 3, DOI: ( /j.ejro ) Copyright © 2016 The Author(s) Terms and Conditions

4 Fig. 3 (A–F) 62-year-old patient with abnormal liver function tests. Axial T2-weighted image (A) and conventional coronal thick-slab single-shot MRC (B) well exhibit dilation of extrahepatic biliary tree and a signal void in the distal portion of the common bile duct. Axial (C) and coronal (D) Mn-DPDP-enhanced T1-weighted images depict stone as a low signal intensity filling defect in contrast-filled bile ducts (white arrow). 3D MIP reconstruction (E) also demonstrates narrowing of the terminal portion of recipient’s common bile duct. Stone was endoscopically removed as confirmed at post-ERCP direct cholangiography (F). European Journal of Radiology Open 2016 3, DOI: ( /j.ejro ) Copyright © 2016 The Author(s) Terms and Conditions

5 Fig. 4 (A–C) 58-year-old woman with abdominal pain. Conventional coronal thick-slab single-shot MRC (A) and MIP reconstructions from 3D-T2-weighted images (B) show an huge sub-hepatic fluid collection partially obscuring the biliary tract. MIP reconstructions obtained from Mn-DPDP-enhanced 3D T1-weighted MRC (C) demonstrate the presence of a leakage at the anastomotic with contrast-enhanced bile filling of the sub-hepatic collection (white arrows). European Journal of Radiology Open 2016 3, DOI: ( /j.ejro ) Copyright © 2016 The Author(s) Terms and Conditions

6 Fig. 5 Graph shows ROC analysis of two image sets (conventional T2-weighted MRC image set versus all images set including Mn-DPDP-enhanced MRC) concerning the level of confidence in the diagnosis of biliary adverse events (p=0.001). European Journal of Radiology Open 2016 3, DOI: ( /j.ejro ) Copyright © 2016 The Author(s) Terms and Conditions

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