Evaluation of the efficacy and reproducibility of cholangiopancreatography by magnetic resonance for detecting biliary complications following orthotopic liver transplantation

Detalhes bibliográficos
Autor(a) principal: Linhares, Marcelo Moura [UNIFESP]
Data de Publicação: 2010
Outros Autores: 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]
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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spelling 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
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