# All About Multiparametric MRI Evaluation in Biliary Tree Complications After Liver Transplant

## TL;DR

This paper explores how multiparametric MRI helps diagnose and manage biliary complications after liver transplants, emphasizing its role in personalized patient care.

## Contribution

The study provides a comprehensive analysis of MPMRI's role in diagnosing various biliary complications post-liver transplant.

## Key findings

- Anastomotic strictures were the most common biliary complication (74%).
- MPMRI was effective in identifying bile leaks, cholangitis, and other post-transplant biliary issues.
- The study highlights MPMRI's adaptability based on clinical context and patient status.

## Abstract

Background/Objectives: To present, discuss, and illustrate the role of multiparametric magnetic resonance imaging (MPMRI) in the evaluation of biliary tree (BT) complications after liver transplantation (LT) as an integrated part into the multidisciplinary team approach for personalized patients’ treatment. Methods: We retrospectively analyzed the MPMRI findings of 317 patients out of 1080 cases with LT, admitted to the Fundeni Clinical Institute from January 2005 to June 2025, who developed biliary complications. Results: Biliary complications after LT evaluated by MPMRI included anastomotic strictures in 235 cases (74%), intra- or extrahepatic bile leaks/biloma in 56 patients (18%), secondary cholangitis due to pyogenic cholangitis in 91 cases (29%), liver abscesses in 23 patients (7%), BT lithiasis in 27 patients (8.5%), disease recurrence in 26 cases (8%), and extrinsic BT compression in 1 case (0.3%). Conclusions: MPMRI plays a crucial role for the evaluation of BT complications, with the protocol being optimized in correlation with the clinical question or suspicion and with the clinical status of the patient.