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MRCP Findings of Biliary Complication after Liver Transplantation

HE Bing-jun,LIU Jing-jing,WANG Jin,YAN Rong-hua,LIANG Ying-ying,REN Ling-lan,SHAN Hong(Departments of Radiology,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)  
【Objective】 To discussion the findings of MRCP on ischemic-type biliary lesions after liver transplantation.【Methods】 Thirty-two cases with ischemic-type biliary lesions(ITBL) and nine cases with anastomotic strictures(AS) after liver transplantation on bases of PTC or ERCP examination and pathology were selected.MRCP images of biliary tree were observed.【Results】 ITBL was classified into three types on the base of the location and range of bile duct lesion: porta hepatis type(Ⅰ type),extensive type(Ⅱ type) and intrahepatic type(Ⅲ type).Fifteen cases were Ⅰ type.MRCP mainly showed absent or thin bile signal at the level of common bile duct,common hepatic duct,confluence and left or right hepatic duct and second level bile ducts.Thirteen cases were Ⅱ type.Segmental bile signal,irregular stenosis and dilation at the level of intrahepatic and extrahepatic bile ducts was observed on MRCP.Four cases were Ⅲ type.Irregular,segmental and string-of-beads stenosis and dilation at the level of intrahepatic small bile ducts can be seen on MRCP.And 25 ITBL cases(78.1%,25/32) had sludge formation in the lumen of donor common hepatic duct,confluence and left and(or) right hepatic duct.MRCP presents signal filling defects in the lumen.Porta hepatis effusion and bile lake have 4 and 3 cases,respectively.AS appears on MRCP as local stenosis of anastomosis with dilation of the bile ducts proximal to the stenosis.Three AS patients(33.3%,3/9) had sludge formation in the lumen of bile ducts.【Conclusions】 MRCP,as a simple,practical and non-invasive way,plays an important role in the diagnosis and classification of biliary complications after liver transplantation with the ability of showing the location and range of bile duct lesion.
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