The role of magnetic resonance cholangiography for recipients after living donor liver transplantation

This is a retrospective study. The purpose of this study was to assess the diagnostic accuracy and utility of posttransplant magnetic resonance cholangiography (MRC) in detecting biliary complications and planning the treatment. From July 2006 to April 2010, 51 (19%) of these 268 adult living-donor liver transplantation (LDLT) recipients were referred to MRC due to biliary dilatation and abnormalities detected by ultrasound or abnormal liver function. The biliary complications were treated with endoscopic or percutaneous transhepatic approach. Among those 51 recipients, MRC revealed no definite biliary pathology in 34 patients. In 10 of the 34 MRC-negative cases, additional MR angiography showed vascular stenosis. 15 MRC-positive cases were correctly assessed the site of the obstruction, bile leakage or lithiasis. Under MRC guidance, biliary interventions were completed in 12 of the MRC-positive cases. MRC achieved sensitivity of 100%, specificity of 94.4%, positive predictive value of 88.2%, and negative predictive value of 100%. MRC is a reliable diagnostic modality in detecting post-transplant biliary complications with 96.1% accuracy. It is an essential diagnostic tool for assessing the necessity for interventional procedure. MR angiography can provide additional information on vascular problems that caused biliary complications. Magnetic resonance imaging (MRI) is thus indispensable before therapeutic biliary or vascular procedure in post-transplant recipients.