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MRI and MRA evaluation of simultaneous pancreas-kidney transplantation

ZHU Wenzhen,XIA Liming,QI Jianpin,et al.Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030  
Objective:To evaluate the value of magnetic resonance imaging(MRI)and three dimensional(3D)contrast magnetic resonance angiography (MRA) for the diagnosis of complications of simultaneous pancreas kidney transplantation (SPKT),as confirmed by biopsy and digital subtraction angiography (DSA).Methods:MR examinations of five patients were performed within 7d~2a after surgery on GE 1.5T MR system.Imaging techniques included axial and saggital chemical fat suppressed T 1 weighted images (T 1WI) and T 2 weighted images (T 2WI), additional contrast axial or saggital chemical fat suppressed T 1WI were obtained after 3D contrast MRA for calculating the mean percentage of parenchymal enhancement (MPPE) of pancreas and kidney. MRCP and MRU were obtained by single shot FSE sequence.3D contrast MRA was performed with Smartprep technique.MRA data was analyzed with maximum intensity projection (MIP) and multiplanar reformation (MPR).Results:In five transplant pancreas,MRI found two normal pancreas grafts,one case of acute rejection,one case of chronic rejection with 70% fibrosis and one case of late pancreatitis. In five transplant kidneys,MRI detected four normal kidney grafts and one case of acute rejection with infarction.MPPE could distinguish infarction from other complications.3D contrast MRA could display vascular complications of SPKT,such as stenosis or occlusion,aneurysm formation of transplanted vessels and narrowing at the site of anastomosis,as confirmed by DSA.Pancreatic duct and urinary tract could be demonstrated well by MRCP and MRU.Conclusion:With combined application of MRI and 3D contrast MRA,complications of SPKT can be clearly identified.
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