Bile duct diffusion-weighted image hyperintensity predicts intrahepatic biliary complications after ABO-incompatible liver transplantation.

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Radiology Pub Date : 2025-01-01 Epub Date: 2024-07-09 DOI:10.1007/s00330-024-10914-1
Kyowon Gu, Woo Kyoung Jeong, Dong Ik Cha, Jeong Ah Hwang, Jinsoo Rhu, Jong Man Kim, Gyu-Seong Choi, Sun-Young Baek
{"title":"Bile duct diffusion-weighted image hyperintensity predicts intrahepatic biliary complications after ABO-incompatible liver transplantation.","authors":"Kyowon Gu, Woo Kyoung Jeong, Dong Ik Cha, Jeong Ah Hwang, Jinsoo Rhu, Jong Man Kim, Gyu-Seong Choi, Sun-Young Baek","doi":"10.1007/s00330-024-10914-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>We assessed the value of the diffusion-weighted image (DWI) for predicting intrahepatic biliary complications (IHBC) after ABO-incompatible liver transplantation (ABOi-LT), potentially leading to refractory cholangitis.</p><p><strong>Materials and methods: </strong>In this retrospective study at a single center, 56 patients who underwent ABOi-LT from March 2021 to January 2023 were analyzed. All received magnetic resonance cholangiopancreatography (MRCP) and DWI during the postoperative hospitalization. MRCP findings, including bile duct DWI hyperintensity, were assessed. Participants suspected of having a biliary infection or obstructive jaundice underwent endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) during the follow-up. Non-anastomotic biliary strictures on cholangiography were classified as IHBC, as either perihilar or diffuse form. DWI hyperintensity was compared between groups with and without IHBC. Logistic regression analysis was performed to identify independent risk factors for IHBC.</p><p><strong>Results: </strong>Of the 55 participants (median age 55 years, 39 males), IHBC was diagnosed in eight patients over a median follow-up of 15.9 months (range 5.6-31.1). Bile duct DWI hyperintensity was observed in 18 patients. Those with DWI hyperintensity exhibited a higher IHBC incidence (6/18, 33.3% vs. 2/36, 5.6%; p = 0.01), and more frequently developed the diffuse type IHBC (4/18, 22.2% vs. 1/36, 2.8%; p = 0.04). Regression analysis indicated that bile duct DWI hyperintensity is an independent risk factor for IHBC (odds ratio (OR) 10.1; 95% confidence interval (CI) 1.4, 71.2; p = 0.02) and its diffuse form (OR 15.3; 95% CI 1.2, 187.8; p = 0.03).</p><p><strong>Conclusion: </strong>Postoperative DWI hyperintensity of bile ducts can serve as a biomarker predicting IHBC after ABOi-LT.</p><p><strong>Clinical relevance statement: </strong>Postoperative diffusion-weighted image hyperintensity of the bile duct can be used as a biomarker to predict intrahepatic biliary complications and aid in identifying candidates who may benefit from additional management for antibody-mediated rejection.</p><p><strong>Key points: </strong>Intrahepatic biliary complications following ABO-incompatible liver transplantation can cause biliary stricture and biloma formation. Bile duct hyperintensity on early postoperative diffusion-weighted imaging was associated with increased intrahepatic biliary complication risk. This marker is an additional method for identifying individuals who require intensive management to prevent complications.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"393-403"},"PeriodicalIF":4.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-024-10914-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: We assessed the value of the diffusion-weighted image (DWI) for predicting intrahepatic biliary complications (IHBC) after ABO-incompatible liver transplantation (ABOi-LT), potentially leading to refractory cholangitis.

Materials and methods: In this retrospective study at a single center, 56 patients who underwent ABOi-LT from March 2021 to January 2023 were analyzed. All received magnetic resonance cholangiopancreatography (MRCP) and DWI during the postoperative hospitalization. MRCP findings, including bile duct DWI hyperintensity, were assessed. Participants suspected of having a biliary infection or obstructive jaundice underwent endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) during the follow-up. Non-anastomotic biliary strictures on cholangiography were classified as IHBC, as either perihilar or diffuse form. DWI hyperintensity was compared between groups with and without IHBC. Logistic regression analysis was performed to identify independent risk factors for IHBC.

Results: Of the 55 participants (median age 55 years, 39 males), IHBC was diagnosed in eight patients over a median follow-up of 15.9 months (range 5.6-31.1). Bile duct DWI hyperintensity was observed in 18 patients. Those with DWI hyperintensity exhibited a higher IHBC incidence (6/18, 33.3% vs. 2/36, 5.6%; p = 0.01), and more frequently developed the diffuse type IHBC (4/18, 22.2% vs. 1/36, 2.8%; p = 0.04). Regression analysis indicated that bile duct DWI hyperintensity is an independent risk factor for IHBC (odds ratio (OR) 10.1; 95% confidence interval (CI) 1.4, 71.2; p = 0.02) and its diffuse form (OR 15.3; 95% CI 1.2, 187.8; p = 0.03).

Conclusion: Postoperative DWI hyperintensity of bile ducts can serve as a biomarker predicting IHBC after ABOi-LT.

Clinical relevance statement: Postoperative diffusion-weighted image hyperintensity of the bile duct can be used as a biomarker to predict intrahepatic biliary complications and aid in identifying candidates who may benefit from additional management for antibody-mediated rejection.

Key points: Intrahepatic biliary complications following ABO-incompatible liver transplantation can cause biliary stricture and biloma formation. Bile duct hyperintensity on early postoperative diffusion-weighted imaging was associated with increased intrahepatic biliary complication risk. This marker is an additional method for identifying individuals who require intensive management to prevent complications.

Abstract Image

胆管弥散加权成像高密度可预测ABO血型不相容肝移植后的肝内胆道并发症。
研究目的我们评估了弥散加权成像(DWI)预测ABO不相容肝移植(ABOi-LT)后肝内胆道并发症(IHBC)的价值,这种并发症可能导致难治性胆管炎:在这项单一中心的回顾性研究中,对2021年3月至2023年1月期间接受ABOi-LT的56例患者进行了分析。所有患者均在术后住院期间接受了磁共振胆胰管造影(MRCP)和 DWI 检查。对 MRCP 结果(包括胆管 DWI 高密度)进行了评估。疑似胆道感染或梗阻性黄疸的患者在随访期间接受了内镜逆行胰胆管造影术(ERCP)或经皮经肝胆管引流术(PTBD)。胆管造影显示的非吻合口胆道狭窄被归类为IHBC,分为周围型和弥漫型。比较有 IHBC 和无 IHBC 组的 DWI 高密度。为确定IHBC的独立风险因素,进行了逻辑回归分析:在 55 名参与者(中位年龄 55 岁,39 名男性)中,有 8 名患者在中位随访 15.9 个月(5.6-31.1 个月)后确诊为 IHBC。在 18 名患者中观察到胆管 DWI 高密度。具有 DWI 高密度的患者的 IHBC 发生率更高(6/18,33.3% vs. 2/36,5.6%;P = 0.01),且更常发展为弥漫型 IHBC(4/18,22.2% vs. 1/36,2.8%;P = 0.04)。回归分析表明,胆管 DWI 高密度是 IHBC(几率比(OR)10.1;95% 置信区间(CI)1.4,71.2;P = 0.02)及其弥漫型(OR 15.3;95% CI 1.2,187.8;P = 0.03)的独立危险因素:结论:术后胆管的DWI高密度可作为预测ABOi-LT术后IHBC的生物标志物:术后胆管弥散加权成像高密度可作为预测肝内胆道并发症的生物标志物,并有助于识别可能从抗体介导的排斥反应额外治疗中获益的候选者:要点:ABO不相容肝移植后的肝内胆道并发症可导致胆道狭窄和胆汁瘤的形成。术后早期弥散加权成像显示的胆管高密度与肝内胆道并发症风险增加有关。这一指标是识别需要加强管理以预防并发症的患者的另一种方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信