Three-dimensional gadolinium-enhanced MR angiography of vascular complications after liver transplantation
J F Glockner1, A R Forauer, H Solomon
1Department of Radiology, St Louis University Hospital, MO 63110-0250, USA.
Objective:
The goal of this study was to evaluate three-dimensional gadolinium-enhanced MR angiography as a tool for examination of liver transplant patients with potential vascular complications.
Materials And Methods:
Thirty-eight consecutive three-dimensional gadolinium-enhanced MR angiograms were obtained in 34 patients. Results were retrospectively reviewed and correlated with conventional angiography in 20 of the 38 cases and sonography in 37 of the 38 cases. MR angiograms were evaluated for technical adequacy, vascular patency, and parenchymal abnormalities, and results were compared with angiography and sonography. Conventional angiography and surgery were used as gold standards when available.
Results:
Thirty-four (90%) of 38 MR angiograms were technically adequate. Vascular abnormalities were identified in 20 patients, and 19 of these patients subsequently underwent angiography, surgery, or both. There were seven cases of hepatic artery thrombosis; all were detected with MR angiography with no false-positive or false-negative interpretations. Seven patients had moderate to severe hepatic artery stenosis (>50% narrowing as determined by conventional angiography). MR angiography revealed this stenosis in six of the seven patients, with one false-negative and three false-positive interpretations. Portal vein thrombosis was detected in three patients, and portal vein stenosis was detected in two patients.
Conclusion:
Three-dimensional gadolinium-enhanced MR angiography is useful in the examination of liver transplant patients and offers a noninvasive adjunct in patients with difficult or indeterminate sonographic examinations.
Insights
Three-dimensional gadolinium-enhanced MR angiography is a useful, noninvasive tool for detecting vascular complications in liver transplant recipients. It accurately identifies hepatic artery thrombosis and portal vein issues, aiding in patient management.
Area of Science:
- Radiology
- Medical Imaging
- Transplant Surgery
Background:
- Liver transplantation is a complex procedure with potential vascular complications.
- Accurate and timely diagnosis of these complications is crucial for patient outcomes.
- Conventional angiography carries risks, and sonography can be limited in certain cases.
Purpose of the Study:
- To assess the efficacy of three-dimensional gadolinium-enhanced MR angiography (3D Gd-MRA) in evaluating vascular complications post-liver transplant.
- To compare the diagnostic performance of 3D Gd-MRA with conventional angiography and sonography.
Main Methods:
- Retrospective review of 38 three-dimensional gadolinium-enhanced MR angiograms in 34 liver transplant patients.
- Evaluation of technical adequacy, vascular patency, and parenchymal abnormalities.
- Correlation of findings with conventional angiography (20 cases) and sonography (37 cases), using surgery and conventional angiography as gold standards.
Main Results:
- 90% of 3D Gd-MRA examinations were technically adequate.
- Hepatic artery thrombosis was detected in 7 patients with 100% accuracy (no false positives/negatives).
- Moderate to severe hepatic artery stenosis was identified in 6 of 7 patients, with high accuracy.
- Portal vein thrombosis and stenosis were also accurately detected.
Conclusions:
- Three-dimensional gadolinium-enhanced MR angiography is a valuable noninvasive imaging modality for liver transplant recipients.
- It serves as an effective adjunct, particularly for patients with challenging or inconclusive sonographic findings.
- 3D Gd-MRA aids in the diagnosis and management of post-transplant vascular complications.
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