Three-Dimensional Gadolinium-Enhanced MR Angiography of Vascular Complications After Liver Transplantation
James F. Glockner1,
Andrew R. Forauer1,2,
Harvey Solomon3,
Chintalapati R. Varma3 and
William H. Perman1
1
Department of Radiology, St. Louis University Hospital, 3635 Vista Ave. at
Grand Blvd., P.O. Box 15250, St. Louis, MO 63110-0250.
2
Present address: Department of Radiology, University of Michigan, B1F510 UH,
1500 E. Medical Center Dr., Ann Arbor, MI 48109-0030.
3
Department of Surgery, St. Louis University Hospital, St. Louis, MO
63110-0250.
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Fig. 1A. —48-year-old man who had undergone liver transplantation and whose
subsequent MR angiographic findings were interpreted as normal. Arterial phase
coronal oblique maximum-intensity-projection (MIP) image shows patent,
moderately redundant hepatic artery with minimal irregularity at anastomosis
(arrow).
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Fig. 1B. —48-year-old man who had undergone liver transplantation and whose
subsequent MR angiographic findings were interpreted as normal. Venous phase
coronal oblique MIP image reveals patent portal vein (arrow) and
hepatic veins (arrowheads).
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Fig. 2. —54-year-old woman with hepatic artery thrombosis. Coronal oblique
maximum-intensity-projection image from MR angiography shows abrupt cutoff of
hepatic artery (arrow). Hepatic artery thrombosis was confirmed at
surgery.
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Fig. 3A. —55-year-old woman with hepatic artery stenosis.
Maximum-intensity-projection image from MR angiography shows severe focal
hepatic artery stenosis (arrowhead) at anastomosis.
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Fig. 3B. —55-year-old woman with hepatic artery stenosis. Conventional
angiogram in projection similar to A shows severe hepatic artery
stenosis (arrowhead).
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Fig. 4A. —44-year-old man with false-positive MR angiographic findings. Axial
oblique maximum-intensity-projection image shows moderate narrowing of hepatic
artery (arrow) at anastomosis. Note diffusely beaded appearance
distally.
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Fig. 5. —55-year-old man with portal vein thrombosis. Coronal oblique
reformatted image from portal venous phase of MR angiography shows
nonocclusive thrombus in main portal vein (arrow). Note irregular
enhancing lesion in right hepatic lobe (arrowheads), representing
recurrent hepatoma.
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Fig. 6A. —45-year-old woman with portal vein stenosis. Coronal
maximum-intensity-projection image from venous phase of MR angiography reveals
marked focal narrowing of main portal vein (arrowhead) with
poststenotic dilatation.
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Fig. 6B. —45-year-old woman with portal vein stenosis. Image from portal phase
of conventional angiography confirms focal portal vein stenosis
(arrowhead).
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Fig. 7. —41-year-old woman with hepatic artery pseudoaneurysm. Coronal
maximum-intensity-projection image from MR angiography shows pseudoaneurysm of
proximal hepatic artery (arrowhead) with distal occlusion.
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Fig. 8. —34-year-old woman with hepatic artery thrombosis and biloma. Coronal
reformatted image from MR angiography shows large rim-enhancing fluid
collection in right hepatic lobe. Also note nonocclusive thrombus in portal
vein confluence (arrowhead).
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Fig. 4B. —44-year-old man with false-positive MR angiographic findings.
Conventional angiogram shows mild anastomotic narrowing (arrowhead)
with normal distal artery. Outpouching of hepatic artery proximal to
bifurcation likely represents cystic artery remnant.
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Copyright © 2000 by the American Roentgen Ray Society.
