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European Radiology

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01-10-2017 | Hepatobiliary-Pancreas

Added value of gadoxetic acid-enhanced T1-weighted magnetic resonance cholangiography for the diagnosis of post-transplant biliary complications

Authors: Sonja Kinner, Tilman B. Schubert, Adnan Said, Joshua D. Mezrich, Scott B. Reeder

Published in: European Radiology | Issue 10/2017

Abstract

Objectives

Biliary complications after liver transplantation (LT) are common. This study aimed to ascertain the value of gadoxetic acid-enhanced T1-weighted (T1w) magnetic resonance cholangiography (MRC) to evaluate anastomotic strictures (AS), non-anastomotic strictures (NAS) and biliary casts (BC).

Methods

Sixty liver-transplanted patients with suspicion of biliary complications and T2w-MRCP and T1w-MRC followed by endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) were analysed. Two readers reviewed the MRCs and rated image quality (IQ) and likelihood for AS/NAS/BC on Likert scales. Sensitivity, specificity and predictive values were calculated, ROC curve analysis performed, and inter-reader variability assessed. The subjective added value of T1w-MRC was rated.

Results

IQ was high for all sequences without significant differences (2.83–2.88). In 39 patients ERCP/PTC detected a complication. Sensitivity and specificity for AS were 64–96 using T2w-MRCP, increasing to 79–100 using all sequences. Use of all sequences increased the sensitivity of detecting NAS/BC from 72–92% to 88–100% and 67–89% to 72–94%, respectively. Kappa values were substantial (0.45–0.62). T1w-MRC was found to be helpful in 75–83.3%.

Conclusions

Combining T1w-MRC and T2w-MRCP increased sensitivity and specificity and diagnostic confidence in patients after LT with suspected biliary complications. T1w-MRC is a valuable tool for evaluating post-transplant biliary complications.

Key Points

• T1w-MRC is a valuable tool for evaluating post-transplant biliary complications.

• Adding T1w-MRC to T2w-MRC increases diagnostic confidence for detection of biliary complications.

• A combination of T1w-MRC and T2w-MRCP leads to the best results.

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Title: Added value of gadoxetic acid-enhanced T1-weighted magnetic resonance cholangiography for the diagnosis of post-transplant biliary complications
Authors: Sonja Kinner
Tilman B. Schubert
Adnan Said
Joshua D. Mezrich
Scott B. Reeder
Publication date: 01-10-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 10/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4797-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Added value of gadoxetic acid-enhanced T1-weighted magnetic resonance cholangiography for the diagnosis of post-transplant biliary complications

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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