MRCP diagnosis of biliary stricture after liver transplantation
WU Jian-wei1, GAO Hong1, LU Guang-ming2
1.Department of Radiology, 81st Hospital of PLA, Nanjing 210002, China;2.Department of Radiology, General Hospital of Nanjing Command PLA, Nanjing 210002, China
Abstract：Objective: To discuss the feasibility of MRCP in the diagnosis of biliary stricture after liver transplantation. Methods: MRCP was performed in 19 patients with suspected biliary stricture in 3 to 10 months after orthotopic liver transplantation(OLT). Diagnostic confirmation was obtained with endoscopic retrograde cholangiopancreatography(ERCP) during one week after MRCP(n=16), two months’ clinical and laboratory follow-up(n=3). Combined with ERCP and clinical follow-up, the value and limitation of MRCP were analysed. Results: Fifteen patients were diagnosed as biliary stircture and had the stent implantation, in one case of whom had normal findings on MRCP and stent was implanted 15 days later because of the aggravation of the biliary obstruction. Two were anastomotic stricture（AS） and 13 nonanastomotic stircture（NAS）. One case with donor-to-recipient common bile duct disproportion was misdiagnosed as anastomotic stricture. Three cases were confirmed to have cholangitis finally. For diagnosis of biliary stricture, MRCP had 93% sensitivity, 75% specificity. Our study showed that the bilary stricture were usually accompanied by the elevation of Alkaline phosphatase and Gamma glutamyl. Conclusion: Compared with ERCP, MRCP can show the biliary stricture correctly after OLT, but cannot discribe the lesions in detail due to the lower resolution and usually exaggerates the extent of stricture. Combined with the monitoring the level of Alkaline phosphatase and Gamma glutamyl, MRCP will provide the diagnosis early.
2007, Vol. 18 
