Effects of magnetic resonance cholangiopancreatographic (MRCP) evaluation on clinical management in liver-transplanted patients with biliary complications: A diagnostic yield study.

Purpose: to assess the results of MRCP as the only imaging modality in the management of liver transplanted patients with suspected biliary complications. Methods and Materials: in the period October 2004-July 2006 17 liver transplanted patients with clinical suspicion of biliary complications underwent MRCP on a 1.5T system equipped with a surface body coil, using a heavy T2-weighted TSE 3D sequence with the multislice technique. The clinical history of subjects has been retrospectively evaluated to determine the diagnostic accuracy of MRCP and the effects on the patient management. Diagnostic confirmation of MRCP findings was obtained with therapeutic direct cholangiography (n=7) and clinical follow-up (n=10). Results: MRCP detected pathologic findings in 11/17 cases (64,7%) (C.I.95%:[0,41;0,87]), changing the initial clinical diagnosis in a significant proportion of subjects (6/17; 35,3%) (p<0,05). Due to MRCP findings, patients were addressed to medical therapy or clinical follow-up in 10 cases (58,8%) and to surgery or interventional procedures in 7 cases (41,2%). MRCP showed a sensitivity, PPV and overall accuracy of 100%. All patients appeared to benefit from the execution of the MRCP (p<0,05), especially 11/17 cases with pathologic findings. Conclusion: MRCP is a safe and reliable tool in addressing the adequate management of patients with biliary complications after orthotopic liver transplantation. Purpose: to assess the results of MRCP as the only imaging modality in the management of liver transplanted patients with suspected biliary complications. Methods and Materials: in the period October 2004-July 2006 17 liver transplanted patients with clinical suspicion of biliary complications underwent MRCP on a 1.5T system equipped with a surface body coil, using a heavy T2-weighted TSE 3D sequence with the multislice technique. The clinical history of subjects has been retrospectively evaluated to determine the diagnostic accuracy of MRCP and the effects on the patient management. Diagnostic confirmation of MRCP findings was obtained with therapeutic direct cholangiography (n=7) and clinical follow-up (n=10). Results: MRCP detected pathologic findings in 11/17 cases (64,7%) (C.I.95%:[0,41;0,87]), changing the initial clinical diagnosis in a significant proportion of subjects (6/17; 35,3%) (p<0,05). Due to MRCP findings, patients were addressed to medical therapy or clinical follow-up in 10 cases (58,8%) and to surgery or interventional procedures in 7 cases (41,2%). MRCP showed a sensitivity, PPV and overall accuracy of 100%. All patients appeared to benefit from the execution of the MRCP (p<0,05), especially 11/17 cases with pathologic findings. Conclusion: MRCP is a safe and reliable tool in addressing the adequate management of patients with biliary complications after orthotopic liver transplantation.