Assessment of Liver Transplant Grafts on Gadoxetic Acid Enhanced-MRI in Pediatric Patients

A wide spectrum of neonatal and pediatric liver diseases can be successfully treated by liver Transplantation (LT). During the last sixty years, refined diagnostic and surgical techniques, improvements in perioperative care, and the advent of better immunosuppressive medications have established LT as a viable treatment option for acute and chronic liver failure in children. As clinical and laboratory findings of LT complications are often nonspecific, imaging tests play a major role in both diagnosis and guidance of therapeutic interventions. In this article, we wanted to emphasize the potential role of gadoxetic acid-enhanced MRI in the evaluation of liver transplant grafts in the pediatric population.We included seven pediatric patients who underwent gadotexic acid-enhanced MRI with different operative procedures. Our series suggests potentially added value of gadoxetic acid for the evaluation of morphologic LT complications, i.e., vascular, biliary, or anastomotic obstruction, as well as parenchymal disorders, including global or segmental (for example, auxiliary LT) hepatobiliary dysfunction. Gadoxetic acid-enhanced MRI showed its ability to depict morphological or anatomical postoperative complications, including vascular occlusion or biliary strictures. Contrary to the conventional imaging modalities or nuclear medicine exams, gadoxetic acid-enhanced MRI can also provide us simultaneously with global and segmental functional information, with high spatial resolution and no radiation exposure. In this article, we show our imaging experience using gadoxetic acidenhanced MRI in the evaluation of LT in children, and its superiority to US, CT, and conventional MRI, by providing anatomic and functional data about the graft.