Case Report
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World J Gastroenterol. Sep 28, 2013; 19(36): 6110-6113
Published online Sep 28, 2013. doi: 10.3748/wjg.v19.i36.6110
Magnetic resonance venography and liver transplant complications
Evgeny Strovski, Dave Liu, Charles Scudamore, Stephen Ho, Eric Yoshida, Darren Klass
Evgeny Strovski, Dave Liu, Stephen Ho, Darren Klass, Division of Interventional Radiology, Department of Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
Charles Scudamore, Division of Hepatobiliary Surgery, Department of Surgery, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
Eric Yoshida, Division of Gastroenterology, Faculty of Medicine, University of British Columbia, Vancouver General Hospital, Vancouver, BC V5Z 1M9, Canada
Author contributions: Strovski E, Liu D, Scudamore C, Ho S, Yoshida E and Klass D contributed to the literature search, concept, manuscript writing and editing.
Correspondence to: Evgeny Strovski, MD, Division of Interventional Radiology, Department of Radiology, University of British Columbia, Vancouver General Hospital, 899 W 12th Ave, Vancouver, BC V5Z 1M9, Canada. estrovski@gmail.com
Telephone: +1-604-8755000 Fax: +1-604-8754723
Received: November 28, 2012
Revised: January 16, 2013
Accepted: March 8, 2013
Published online: September 28, 2013
Processing time: 302 Days and 7.6 Hours
Abstract

Hepatic vein stenosis is a rare but serious complication following liver transplantation. Multiple modalities can be utilized to image the hepatic vasculature. Magnetic resonance venography (MRV) provides certain advantages over ultrasound, computed tomography angiography and digital subtraction venography. MRV utilizes the same imaging principles of magnetic resonance angiography in order to image the venous system. Blood pool contrast agents, specifically gadofosveset trisodium, allow for steady state imaging up to 1 h following injection, with improved visualisation of vital venous structures by utilising delayed steady state imaging. Additionally, the inherent physics properties of magnetic resonance imaging also provide excellent soft tissue detail and thus help define the extent of complications that often plague the post-liver transplant patient. This case report describes the use of gadofosveset trisodium in a patient with hepatic venous stenosis following liver transplantation. Initial venography failed to outline the stenoses and thus MRV using a blood pool contrast agent was utilised in order to delineate the anatomy and plan a therapeutic endovascular procedure.

Keywords: Magnetic resonance venography; Blood pool; Magnetic resonance angiography; Nephrogenic systemic fibrosis; Liver transplant; Gadofosveset trisodium