Clinical Application Of Magnetic Resonance Imaging In Diagnosis Of Complications After Liver Transplantation

Objective: We sought to evaluate MRCP,DWI and MRS as the imaging procedure used in the diagnosis of complications and rejection after ortho-topic liver transplantation (OLT). Methods: 1. 54 consecutive patients underwent MRCP. The imaging findings were analyzed and compared with the findings eventually confirmed by surgery, direct cholangiography, or clinical follow-up.2. dynamic study of DWI was performed in standard water model,20 healthy liver and 20 consecutive patients post-transplantation.3. Sixteen liver transplant recipientsand 18 controls were studied with in vivo ³¹P- MRS. Results: 1. MRCP imaging alone was able to provide a specific diagnosis in 96.3%(52/54)of the patients and ERCP and PTHC were required in only two patients. 2. The decreases of ADC values in hepatic lobal with rejection were obvious compared to non- rejection lobal. 3. The peak area ratios of PME and PDE in biliary duct stricture group and chronic rejection group was higher than control groups. The ratios ofβ-ATP/Pi and PME/Pi decreased in biliary duct stricture group, while increasing in chronic rejection group.Conclusion : 1.MRCP is a useful imaging procedure in the assessment of biliary complications after OLT. Direct cholangiography is not needed for diagnosis and should be reserved for therapeutic procedures.2. DWI method can reflect ealier diffusion state of rejection after transplantation than traditional MR imaging. The measurement of ADC value is a meaningful auxiliary diagnostic criteria for early rejection. 3.³¹P-MRS imaging is valuable in detecting the metabolism of the liver after transplanatation.It does suggest that further investigation of alterations in phospholipid metabolism may be a useful future direction of research.