Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
dARK ID: | ark:/48912/0013000018zfv |
Texto Completo: | http://dx.doi.org/10.1590/S0102-86502010000300006 http://repositorio.unifesp.br/handle/11600/5779 |
Resumo: | PURPOSE: To evaluate the accuracy and reproducibility of magnetic resonance cholangiopancreatography (MRCP) in the detection of biliary complications in liver transplanted patients. METHODS: A study was conducted, with blinded review of 28 MRCP exams of 24 patients submitted to liver transplantation. The images were reviewed by two independent observers, at two different moments, regarding the degree of biliary tree visualization and the presence or absence of biliary complications. The MRCP results were compared, when negative, to at least 3 months of clinical and biochemical follow-up, and when positive, to the findings at surgery or endoscopic retrograde cholangiopancreatography (ERCP). RESULTS: The degree of intrahepatic biliary tree visualization was considered good or excellent in 78.6% and 82.1% of the exams by the two observers and visualization of the donor duct, recipient duct and biliary anastomosis was considered good or excellent in 100% of the exams, by both observers. Six biliary complications were detected (21.4%), all of them anastomotic strictures. Intra and interobserver agreement were substantial or almost perfect (kappa k values of 0.611 to 0.804) for the visualization of the biliary tree and almost perfect (k values of 0.900 to 1.000) for the detection of biliary complications. MRCP achieved 100% sensitivity, 95.45% specificity, 85.7% positive predictive value and 100% negative predictive value for the detection of biliary complications. CONCLUSIONS: MRCP is an accurate examination for the detection of biliary complications after orthotopic liver transplantation and it is a highly reproducible method in the evaluation of the biliary tree of liver transplanted patients. |
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Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantationEstudo da eficácia e da reprodutibilidade da colangiopancreatografia por ressonância magnética na detecção das complicações biliares pós-transplantes hepáticosLiver TransplantationMagnetic Resonance ImagingBile DuctsCholangiographyTransplante de FígadoImagem por Ressonância MagnéticaDuctos BiliaresColangiografiaPURPOSE: To evaluate the accuracy and reproducibility of magnetic resonance cholangiopancreatography (MRCP) in the detection of biliary complications in liver transplanted patients. METHODS: A study was conducted, with blinded review of 28 MRCP exams of 24 patients submitted to liver transplantation. The images were reviewed by two independent observers, at two different moments, regarding the degree of biliary tree visualization and the presence or absence of biliary complications. The MRCP results were compared, when negative, to at least 3 months of clinical and biochemical follow-up, and when positive, to the findings at surgery or endoscopic retrograde cholangiopancreatography (ERCP). RESULTS: The degree of intrahepatic biliary tree visualization was considered good or excellent in 78.6% and 82.1% of the exams by the two observers and visualization of the donor duct, recipient duct and biliary anastomosis was considered good or excellent in 100% of the exams, by both observers. Six biliary complications were detected (21.4%), all of them anastomotic strictures. Intra and interobserver agreement were substantial or almost perfect (kappa k values of 0.611 to 0.804) for the visualization of the biliary tree and almost perfect (k values of 0.900 to 1.000) for the detection of biliary complications. MRCP achieved 100% sensitivity, 95.45% specificity, 85.7% positive predictive value and 100% negative predictive value for the detection of biliary complications. CONCLUSIONS: MRCP is an accurate examination for the detection of biliary complications after orthotopic liver transplantation and it is a highly reproducible method in the evaluation of the biliary tree of liver transplanted patients.OBJETIVO: Medir a acurácia e reprodutibilidade da colangiopancreatografia por ressonância magnética (CPRM) na avaliação da visibilização de complicações biliares em pacientes submetidos a transplantes hepáticos ortotópicos. MÉTODOS: Realizado estudo retrospectivo de 28 exames de CPRM de 24 pacientes submetidos a transplantes hepáticos. Os exames foram interpretados por dois observadores independentes, em dois momentos distintos, quanto ao grau de visibilização das estruturas estudadas e quanto à presença ou ausência de alterações nas vias biliares. Os resultados da CPRM foram comparados, nos casos de CPRM negativa, à evolução clínico-laboratorial por pelo menos 3 meses e, nos casos de CPRM alterada, aos achados de colangiopancreatografia retrógrada endoscópica (CPRE) e cirurgia, quando indicados. RESULTADOS: A visibilização das vias biliares intra-hepáticas foi considerada boa ou excelente em 78,6% e 82,1% dos exames pelos dois observadores. A visibilização da via biliar extra-hepática do doador e do receptor, bem como da anastomose biliar, foi considerada boa ou excelente em 100% dos casos por ambos os observadores. Foram detectadas seis complicações biliares (21,4% dos casos), todas elas estenoses anastomóticas. A concordância intra e intra-observador foi substancial ou quase perfeita (índices de kappa- k de 0,611 a 0,804) para a visualização das estruturas estudadas e quase perfeita (k de 0,900 a 1,000) para a detecção das complicações biliares. A CPRM apresentou sensibilidade de 100%, especificidade de 95,45%, valor preditivo positivo de 85,7% e valor preditivo negativo de 100% para a detecção de complicações biliares. CONCLUSÕES: A colangiopancreatografia por ressonância magnética (CPRM) é um exame acurado para a detecção de complicações biliares em pacientes submetidos a transplantes hepáticos ortotópicos por CPRM. Este exame configura-se como um método eficiente e altamente reprodutível para detecção de complicações biliares pós-transplantes hepáticos ortotópicos.Universidade Federal de São Paulo (UNIFESP) Department of SurgeryUniversidade Federal de São Paulo (UNIFESP) Department of Image DiagnosticUniversidade Federal de São Paulo (UNIFESP) Department of MedicineUniversidade Federal de São Paulo (UNIFESP) Department of Surgery Division of Liver TransplantationUniversidade Federal de São Paulo (UNIFESP) Department of Surgery Division of Surgical GastroenterologyUNIFESP, Department of SurgeryUNIFESP, Department of Image DiagnosticUNIFESP, Department of MedicineUNIFESP, Department of Surgery Division of Liver TransplantationUNIFESP, Department of Surgery Division of Surgical GastroenterologySciELOSociedade Brasileira para o Desenvolvimento da Pesquisa em CirurgiaUniversidade Federal de São Paulo (UNIFESP)Linhares, Marcelo Moura [UNIFESP]Coelho, Rafael Darahen de Souza [UNIFESP]Szejnfeld, Jacob [UNIFESP]Goldman, Susan Menasce [UNIFESP]Gonzalez, Adriano Miziara [UNIFESP]Szejnfeld, Denis [UNIFESP]Matos, Carla Adriana Loureiro de [UNIFESP]Salzedas-Netto, Alcides Augusto [UNIFESP]Goldenberg, Alberto [UNIFESP]Lopes Filho, Gaspar de Jesus [UNIFESP]Matos, Delcio [UNIFESP]2015-06-14T13:41:43Z2015-06-14T13:41:43Z2010-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion249-256application/pdfhttp://dx.doi.org/10.1590/S0102-86502010000300006Acta Cirurgica Brasileira. Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, v. 25, n. 3, p. 249-256, 2010.10.1590/S0102-86502010000300006S0102-86502010000300006.pdf0102-8650S0102-86502010000300006http://repositorio.unifesp.br/handle/11600/5779WOS:000279280900006ark:/48912/0013000018zfvengActa Cirurgica Brasileirainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T18:21:42Zoai:repositorio.unifesp.br/:11600/5779Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-12-11T21:04:42.075492Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation Estudo da eficácia e da reprodutibilidade da colangiopancreatografia por ressonância magnética na detecção das complicações biliares pós-transplantes hepáticos |
title |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation |
spellingShingle |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation Linhares, Marcelo Moura [UNIFESP] Liver Transplantation Magnetic Resonance Imaging Bile Ducts Cholangiography Transplante de Fígado Imagem por Ressonância Magnética Ductos Biliares Colangiografia |
title_short |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation |
title_full |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation |
title_fullStr |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation |
title_full_unstemmed |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation |
title_sort |
Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation |
author |
Linhares, Marcelo Moura [UNIFESP] |
author_facet |
Linhares, Marcelo Moura [UNIFESP] Coelho, Rafael Darahen de Souza [UNIFESP] Szejnfeld, Jacob [UNIFESP] Goldman, Susan Menasce [UNIFESP] Gonzalez, Adriano Miziara [UNIFESP] Szejnfeld, Denis [UNIFESP] Matos, Carla Adriana Loureiro de [UNIFESP] Salzedas-Netto, Alcides Augusto [UNIFESP] Goldenberg, Alberto [UNIFESP] Lopes Filho, Gaspar de Jesus [UNIFESP] Matos, Delcio [UNIFESP] |
author_role |
author |
author2 |
Coelho, Rafael Darahen de Souza [UNIFESP] Szejnfeld, Jacob [UNIFESP] Goldman, Susan Menasce [UNIFESP] Gonzalez, Adriano Miziara [UNIFESP] Szejnfeld, Denis [UNIFESP] Matos, Carla Adriana Loureiro de [UNIFESP] Salzedas-Netto, Alcides Augusto [UNIFESP] Goldenberg, Alberto [UNIFESP] Lopes Filho, Gaspar de Jesus [UNIFESP] Matos, Delcio [UNIFESP] |
author2_role |
author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Linhares, Marcelo Moura [UNIFESP] Coelho, Rafael Darahen de Souza [UNIFESP] Szejnfeld, Jacob [UNIFESP] Goldman, Susan Menasce [UNIFESP] Gonzalez, Adriano Miziara [UNIFESP] Szejnfeld, Denis [UNIFESP] Matos, Carla Adriana Loureiro de [UNIFESP] Salzedas-Netto, Alcides Augusto [UNIFESP] Goldenberg, Alberto [UNIFESP] Lopes Filho, Gaspar de Jesus [UNIFESP] Matos, Delcio [UNIFESP] |
dc.subject.por.fl_str_mv |
Liver Transplantation Magnetic Resonance Imaging Bile Ducts Cholangiography Transplante de Fígado Imagem por Ressonância Magnética Ductos Biliares Colangiografia |
topic |
Liver Transplantation Magnetic Resonance Imaging Bile Ducts Cholangiography Transplante de Fígado Imagem por Ressonância Magnética Ductos Biliares Colangiografia |
description |
PURPOSE: To evaluate the accuracy and reproducibility of magnetic resonance cholangiopancreatography (MRCP) in the detection of biliary complications in liver transplanted patients. METHODS: A study was conducted, with blinded review of 28 MRCP exams of 24 patients submitted to liver transplantation. The images were reviewed by two independent observers, at two different moments, regarding the degree of biliary tree visualization and the presence or absence of biliary complications. The MRCP results were compared, when negative, to at least 3 months of clinical and biochemical follow-up, and when positive, to the findings at surgery or endoscopic retrograde cholangiopancreatography (ERCP). RESULTS: The degree of intrahepatic biliary tree visualization was considered good or excellent in 78.6% and 82.1% of the exams by the two observers and visualization of the donor duct, recipient duct and biliary anastomosis was considered good or excellent in 100% of the exams, by both observers. Six biliary complications were detected (21.4%), all of them anastomotic strictures. Intra and interobserver agreement were substantial or almost perfect (kappa k values of 0.611 to 0.804) for the visualization of the biliary tree and almost perfect (k values of 0.900 to 1.000) for the detection of biliary complications. MRCP achieved 100% sensitivity, 95.45% specificity, 85.7% positive predictive value and 100% negative predictive value for the detection of biliary complications. CONCLUSIONS: MRCP is an accurate examination for the detection of biliary complications after orthotopic liver transplantation and it is a highly reproducible method in the evaluation of the biliary tree of liver transplanted patients. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-06-01 2015-06-14T13:41:43Z 2015-06-14T13:41:43Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0102-86502010000300006 Acta Cirurgica Brasileira. Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, v. 25, n. 3, p. 249-256, 2010. 10.1590/S0102-86502010000300006 S0102-86502010000300006.pdf 0102-8650 S0102-86502010000300006 http://repositorio.unifesp.br/handle/11600/5779 WOS:000279280900006 |
dc.identifier.dark.fl_str_mv |
ark:/48912/0013000018zfv |
url |
http://dx.doi.org/10.1590/S0102-86502010000300006 http://repositorio.unifesp.br/handle/11600/5779 |
identifier_str_mv |
Acta Cirurgica Brasileira. Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, v. 25, n. 3, p. 249-256, 2010. 10.1590/S0102-86502010000300006 S0102-86502010000300006.pdf 0102-8650 S0102-86502010000300006 WOS:000279280900006 ark:/48912/0013000018zfv |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Acta Cirurgica Brasileira |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
249-256 application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
publisher.none.fl_str_mv |
Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
_version_ |
1818602598022774784 |