Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2014; 6(7): 424-436
Published online Jul 28, 2014. doi: 10.4329/wjr.v6.i7.424
Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT
Rossano Girometti, Lorenzo Cereser, Massimo Bazzocchi, Chiara Zuiani
Rossano Girometti, Lorenzo Cereser, Massimo Bazzocchi, Chiara Zuiani, Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy
Author contributions: Girometti R and Cereser L wrote the paper; Girometti R, Cereser L, Bazzocchi M and Zuiani C designed the paper; Cereser L, Bazzocchi M and Zuiani C performed literature research; all the authors selected and supervised the editing of study images and tables
Correspondence to: Rossano Girometti, MD, Research Assistant Professor of Radiology, Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, University of Udine, via Colugna n. 50, 33100 Udine, Italy. rgirometti@sirm.org
Telephone: +39-04-32559266 Fax: +39-04-32559867
Received: January 17, 2014
Revised: March 5, 2014
Accepted: May 28, 2014
Published online: July 28, 2014
Processing time: 195 Days and 5.3 Hours
Abstract

Despite advances in patient and graft management, biliary complications (BC) still represent a challenge both in the early and delayed period after orthotopic liver transplantation (OLT). Because of unspecific clinical presentation, imaging is often mandatory in order to diagnose BC. Among imaging modalities, magnetic resonance cholangiography (MRC) has gained widespread acceptance as a tool to represent the reconstructed biliary tree noninvasively, using both the conventional technique (based on heavily T2-weighted sequences) and contrast-enhanced MRC (based on the acquisition of T1-weighted sequences after the administration of hepatobiliary contrast agents). On this basis, MRC is generally indicated to: (1) avoid unnecessary procedures of direct cholangiography in patients with a negative examination and/or identify alternative complications; and (2) provide a road map for interventional procedures or surgery. As illustrated in the review, MRC is accurate in the diagnosis of different types of biliary complications, including anastomotic strictures, non-anastomotic strictures, leakage and stones.

Keywords: Orthotopic liver transplantation; Orthotopic liver transplantation complications; Magnetic resonance imaging cholangiopancreatography; Endoscopic retrograde cholangiography; Bile ducts obstruction

Core tip: The review is focused on three main topics, in order to emphasize why magnetic resonance cholangiography (MRC) is the preferred imaging modality to noninvasively assess the biliary system after orthotopic liver transplantation. First, the authors describe the different techniques that can be used, namely conventional MRC and contrast-enhanced MRC. Second, exemplificative imaging findings are illustrated in order to show the diagnostic reliability of the technique. Third, the Authors discuss the state-of-the-art role for MRC in assessing biliary complications as emerging from updated literature review.