Skip to main content
Top
Published in: Abdominal Radiology 3/2017

01-03-2017

3D T2-weighted and Gd-EOB-DTPA-enhanced 3D T1-weighted MR cholangiography for evaluation of biliary anatomy in living liver donors

Authors: Larry Cai, Benjamin M. Yeh, Antonio C. Westphalen, John Roberts, Zhen J. Wang

Published in: Abdominal Radiology | Issue 3/2017

Login to get access

Abstract

Purpose

To investigate whether the addition of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced 3D T1-weighted MR cholangiography (T1w-MRC) to 3D T2-weighted MRC (T2w-MRC) improves the confidence and diagnostic accuracy of biliary anatomy in living liver donors.

Methods

Two abdominal radiologists retrospectively and independently reviewed pre-operative MR studies in 58 consecutive living liver donors. The second-order bile duct visualization on T1w- and T2w-MRC images was rated on a 4-point scale. The readers also independently recorded the biliary anatomy and their diagnostic confidence using (1) combined T1w- and T2w-MRC, and (2) T2w-MRC. In the 23 right lobe donors, the biliary anatomy at imaging and the imaging-predicted number of duct orifices at surgery were compared to intra-operative findings.

Results

T1w-MRC had a higher proportion of excellent visualization than T2w-MRC, 66% vs. 45% for reader 1 and 60% vs. 31% for reader 2. The median confidence score for biliary anatomy diagnosis was significantly higher with combined T1w- and T2w-MRC than T2w-MRC alone for both readers (Reader 1: 3 vs. 2, p < 0.001; Reader 2: 3 vs. 1, p < 0.001). Compared to intra-operative findings, the accuracy of imaging-predicted number of duct orifices using combined T1w-and T2w-MRC was significantly higher than that using T2w-MRC alone (p = 0.034 for reader 1, p = 0.0082 for reader 2).

Conclusion

The addition of Gd-EOB-DTPA-enhanced 3D T1w-MRC to 3D T2w-MRC improves second-order bile duct visualization and increases the confidence in biliary anatomy diagnosis and the accuracy in the imaging-predicted number of duct orifices acquired during right lobe harvesting.
Literature
1.
go back to reference Bhatti AB, et al. (2015) Quality of life after living donor hepatectomy for liver transplantation. World J Surg 39(9):2300–2305CrossRefPubMed Bhatti AB, et al. (2015) Quality of life after living donor hepatectomy for liver transplantation. World J Surg 39(9):2300–2305CrossRefPubMed
2.
go back to reference Ladner DP, et al. (2015) Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL). J Hepatol 62(2):346–353CrossRefPubMed Ladner DP, et al. (2015) Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL). J Hepatol 62(2):346–353CrossRefPubMed
3.
go back to reference Xu D-W, Long X-D, Xia Q (2015) A review of life quality in living donors after living transplantation. Int J Clin Exp Med 8(1):20–26PubMedPubMedCentral Xu D-W, Long X-D, Xia Q (2015) A review of life quality in living donors after living transplantation. Int J Clin Exp Med 8(1):20–26PubMedPubMedCentral
4.
go back to reference Olthoff KM, et al. (2005) Outcomes of 385 adult-to-adult living donor liver transplant recipients. Ann Surg 242(3):314–325PubMedPubMedCentral Olthoff KM, et al. (2005) Outcomes of 385 adult-to-adult living donor liver transplant recipients. Ann Surg 242(3):314–325PubMedPubMedCentral
5.
go back to reference Suh K-S, et al. (2015) Recent advancements in and views on the donor operation in living donor liver transplantation: a single-center study of 886 patients over 13 years. Liver Transpl 21(3):329–338CrossRefPubMed Suh K-S, et al. (2015) Recent advancements in and views on the donor operation in living donor liver transplantation: a single-center study of 886 patients over 13 years. Liver Transpl 21(3):329–338CrossRefPubMed
6.
go back to reference Parikh ND, Ladner D, Abecassis M, Butt Z (2010) Quality of life for donors after living donor liver transplantation: a review of the literature. Liver Transpl 16(12):1352–1358CrossRefPubMedPubMedCentral Parikh ND, Ladner D, Abecassis M, Butt Z (2010) Quality of life for donors after living donor liver transplantation: a review of the literature. Liver Transpl 16(12):1352–1358CrossRefPubMedPubMedCentral
7.
go back to reference Hoehn RS, et al. (2014) Comparing living donor and deceased donor liver transplantation: a matched national analysis from 2007 to 2012. Liver Transpl 20(11):1347–1355CrossRefPubMed Hoehn RS, et al. (2014) Comparing living donor and deceased donor liver transplantation: a matched national analysis from 2007 to 2012. Liver Transpl 20(11):1347–1355CrossRefPubMed
8.
go back to reference Mortele KJ, Ros PR (2001) Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. AJR Am J Roentgenol 177(2):389–394CrossRefPubMed Mortele KJ, Ros PR (2001) Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. AJR Am J Roentgenol 177(2):389–394CrossRefPubMed
9.
go back to reference Catalano OA, et al. (2008) Vascular and biliary variants in the liver: implications for liver surgery. RadioGraphics 28(2):259–278CrossRef Catalano OA, et al. (2008) Vascular and biliary variants in the liver: implications for liver surgery. RadioGraphics 28(2):259–278CrossRef
10.
go back to reference Brown RS, et al. (2003) A survey of liver transplantation from living adult donors in the United States. N Engl J Med 348(9):818–825CrossRefPubMed Brown RS, et al. (2003) A survey of liver transplantation from living adult donors in the United States. N Engl J Med 348(9):818–825CrossRefPubMed
11.
go back to reference Kochhar G, Parungao JM, Hanouneh IA, Parsi MA (2013) Biliary complications following liver transplantation. World J Gastroenterol 19(19):2841–2846PubMedPubMedCentral Kochhar G, Parungao JM, Hanouneh IA, Parsi MA (2013) Biliary complications following liver transplantation. World J Gastroenterol 19(19):2841–2846PubMedPubMedCentral
12.
go back to reference Umeshita K, et al. (2003) Operative morbidity of living liver donors in Japan. Lancet 362(9385):687–690CrossRefPubMed Umeshita K, et al. (2003) Operative morbidity of living liver donors in Japan. Lancet 362(9385):687–690CrossRefPubMed
13.
go back to reference Kinner S, et al. (2014) Comparison of different magnetic resonance cholangiography techniques in living liver donors including Gd-EOB-DTPA enhanced T1-weighted sequences. PLoS One 9(11):e113882CrossRefPubMedPubMedCentral Kinner S, et al. (2014) Comparison of different magnetic resonance cholangiography techniques in living liver donors including Gd-EOB-DTPA enhanced T1-weighted sequences. PLoS One 9(11):e113882CrossRefPubMedPubMedCentral
14.
go back to reference Lim JS, et al. (2008) MR cholangiography for evaluation of hilar branching anatomy in transplantation of the right hepatic lobe from a living donor. AJR 191(2):537–545CrossRefPubMed Lim JS, et al. (2008) MR cholangiography for evaluation of hilar branching anatomy in transplantation of the right hepatic lobe from a living donor. AJR 191(2):537–545CrossRefPubMed
15.
go back to reference Ragab A, Lopez-Soler RI, Oto A, Testa G (2013) Correlation between 3D-MRCP and intra-operative findings in right liver donors. Hepatobiliary Surg Nutr 2(1):7–13PubMedPubMedCentral Ragab A, Lopez-Soler RI, Oto A, Testa G (2013) Correlation between 3D-MRCP and intra-operative findings in right liver donors. Hepatobiliary Surg Nutr 2(1):7–13PubMedPubMedCentral
16.
go back to reference An SK, et al. (2006) Gadobenate dimeglumine-enhanced liver MRI as the sole preoperative imaging technique: a prospective study of living liver donors. AJR 187(5):1223–1233CrossRefPubMed An SK, et al. (2006) Gadobenate dimeglumine-enhanced liver MRI as the sole preoperative imaging technique: a prospective study of living liver donors. AJR 187(5):1223–1233CrossRefPubMed
17.
go back to reference Lee MS, et al. (2011) Gadoxetic acid disodium-enhanced magnetic resonance imaging for biliary and vascular evaluations in preoperative living liver donors: comparison with gadobenate dimelumine-enhanced MRI. J Magn Reson Imaging 33(1):149–159CrossRefPubMed Lee MS, et al. (2011) Gadoxetic acid disodium-enhanced magnetic resonance imaging for biliary and vascular evaluations in preoperative living liver donors: comparison with gadobenate dimelumine-enhanced MRI. J Magn Reson Imaging 33(1):149–159CrossRefPubMed
18.
go back to reference Mangold S, et al. (2012) MRI for evaluation of potential living liver donors: a new approach including contrast-enhanced magnetic resonance cholangiography. Abdom Imaging 37(2):244–251CrossRefPubMed Mangold S, et al. (2012) MRI for evaluation of potential living liver donors: a new approach including contrast-enhanced magnetic resonance cholangiography. Abdom Imaging 37(2):244–251CrossRefPubMed
19.
go back to reference Puente SG, Bannura GC (1983) Radiological anatomy of the biliary tract: variations and congenital abnormalities. World J Surg 7(2):271–276CrossRefPubMed Puente SG, Bannura GC (1983) Radiological anatomy of the biliary tract: variations and congenital abnormalities. World J Surg 7(2):271–276CrossRefPubMed
20.
go back to reference Kim SY, et al. (2010) Biliary tract depiction in living potential liver donors: intraindividual comparison of MR cholangiography at 3.0 and 1.5 T. Radiology 254(2):469–478CrossRefPubMed Kim SY, et al. (2010) Biliary tract depiction in living potential liver donors: intraindividual comparison of MR cholangiography at 3.0 and 1.5 T. Radiology 254(2):469–478CrossRefPubMed
Metadata
Title
3D T2-weighted and Gd-EOB-DTPA-enhanced 3D T1-weighted MR cholangiography for evaluation of biliary anatomy in living liver donors
Authors
Larry Cai
Benjamin M. Yeh
Antonio C. Westphalen
John Roberts
Zhen J. Wang
Publication date
01-03-2017
Publisher
Springer US
Published in
Abdominal Radiology / Issue 3/2017
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-016-0936-z

Other articles of this Issue 3/2017

Abdominal Radiology 3/2017 Go to the issue