Vascular complications of liver transplantation: evaluation with gadolinium-enhanced MR angiography.

Overview

PURPOSE: To evaluate use of gadolinium-enhanced magnetic resonance (MR) angiography in detection of vascular complications of liver transplantation. MATERIALS AND METHODS: Thirteen liver transplant recipients suspected to have vascular complications were evaluated with gadolinium-enhanced MR angiography by using a three-dimensional spoiled gradient-echo breath-hold technique during the arterial and venous phases of a high-dose (42 mL) bolus injection of gadolinium contrast material. Conventional angiography (n = 11) and surgery (n = 3) were used as the standard of reference. The transplant hepatic artery, celiac trunk, superior mesenteric artery, portal vein, superior mesenteric vein, splenic vein, hepatic veins, and inferior vena cava (IVC) were evaluated for thrombosis or stenosis by two radiologists. RESULTS: Ten vascular complications were identified with conventional angiography or surgery: transplant hepatic artery thrombosis (n = 3) or stenosis (n = 3), portal vein stenosis (n = 1) or occlusion (n = 2), and suprahepatic IVC stenosis (n = 1). All 10 complications were correctly diagnosed with MR angiography. There was agreement between results of MR angiography and conventional angiography or surgery in 58 of 62 vessels evaluated (94%). There was minor disagreement in four vessels (6%). CONCLUSION: Three-dimensional gadolinium-enhanced MR angiography may have the potential to enable accurate diagnosis of vascular complications of liver transplantation.