Abstract
Purpose
To compare the length of the right hepatic duct (RHD) measured on rotatory coronal 2D MR cholangiography (MRC), rotatory axial 2D MRC, and reconstructed 3D MRC.
Materials and methods
Sixty-seven donors underwent coronal and axial 2D projection MRC and 3D MRC. RHD length was measured and categorized as ultrashort (≤1 mm), short (>1-14 mm), and long (>14 mm). The measured length, frequency of overestimation, and the degree of underestimation between two 2D MRC sets were compared to 3D MRC.
Results
The length of the RHD from 3D MRC, coronal 2D MRC, and axial 2D MRC showed significant difference (p < 0.05). RHD was frequently overestimated on the coronal than on axial 2D MRC (61.2 % vs. 9 %; p < .0001). On coronal 2D MRC, four (6 %) with short RHD and one (1.5 %) with ultrashort RHD were over-categorized as long RHD. On axial 2D MRC, overestimation was mostly <1 mm (83.3 %), none exceeding 3 mm or over-categorized. The degree of underestimation between the two projection planes was comparable.
Conclusion
Coronal 2D MRC overestimates the RHD in liver donors. We suggest adding axial 2D MRC to conventional coronal 2D MRC in the preoperative workup protocol for living liver donors to avoid unexpected confrontation with multiple ductal openings when harvesting the graft.
Key Points
• In living liver donors, RHD length influences the number of ductal openings.
• Coronal 2D MRC overestimates the RHD length than does axial 2D MRC.
• Adding axial 2D MRC to coronal 2D MRC may prevent overestimating RHD length.
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References
Fan ST, Lo CM, Liu CL, Tso WK, Wong J (2002) Biliary reconstruction and complications of right lobe live donor liver transplantation. Ann Surg 236:676–683
Kasahara M, Egawa H, Takada Y et al (2006) Biliary reconstruction in right lobe living-donor liver transplantation: comparison of different techniques in 321 recipients. Ann Surg 243:559–566
Kim RD, Sakamoto S, Haider MA et al (2005) Role of magnetic resonance cholangiography in assessing biliary anatomy in right lobe living donors. Transplantation 79:1417–1421
Kashyap R, Bozorgzadeh A, Abt P et al (2008) Stratifying risk of biliary complications in adult living donor liver transplantation by magnetic resonance cholangiography. Transplantation 85:1569–1572
Ishiko T, Egawa H, Kasahara M et al (2002) Duct-to-duct biliary reconstruction in living donor liver transplantation utilizing right lobe graft. Ann Surg 236:235–240
Jeon YM, Lee KW, Yi NJ et al (2013) The right posterior bile duct anatomy of the donor is important in biliary complications of the recipients after living-donor liver transplantation. Ann Surg 257:702–707
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 2:7–13
Limanond P, Raman SS, Ghobrial RM, Busuttil RW, Lu DS (2004) The utility of MRCP in preoperative mapping of biliary anatomy in adult-to-adult living related liver transplant donors. J Magn Reson Imaging 19:209–215
Sirvanci M, Duran C, Ozturk E et al (2007) The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors. Clin Imaging 31:401–405
Song GW, Lee SG, Hwang S et al (2007) Preoperative evaluation of biliary anatomy of donor in living donor liver transplantation by conventional nonenhanced magnetic resonance cholangiography. Transpl Int 20:167–173
Hsu HW, Tsang LL, Yap A et al (2011) Magnetic resonance cholangiography in living donor liver transplantation. Transplantation 92:94–99
Xu YB, Bai YL, Min ZG, Qin SY (2013) Magnetic resonance cholangiography in assessing biliary anatomy in living donors: a meta-analysis. World J Gastroenterol 19:8427–8434
Basaran C, Agildere AM, Donmez FY et al (2008) MR cholangiopancreatography with T2-weighted prospective acquisition correction turbo spin-echo sequence of the biliary anatomy of potential living liver transplant donors. AJR Am J Roentgenol 190:1527–1533
Lee Y, Kim SY, Kim KW et al (2015) Contrast-enhanced MR cholangiography with Gd-EOB-DTPA for preoperative biliary mapping: correlation with intraoperative cholangiography. Acta Radiol 56:773–781
Ogul H, Kantarci M, Pirimoglu B et al (2014) The efficiency of Gd-EOB-DTPA-enhanced magnetic resonance cholangiography in living donor liver transplantation: a preliminary study. Clin Transplant 28:354–360
Kinner S, Steinweg V, Maderwald S et al (2014) Bile duct evaluation of potential living liver donors with Gd-EOB-DTPA enhanced MR cholangiography: Single-dose, double dose or half-dose contrast enhanced imaging. Eur J Radiol 83:763–767
Lim JS, Kim MJ, Myoung S et al (2008) MR cholangiography for evaluation of hilar branching anatomy in transplantation of the right hepatic lobe from a living donor. AJR Am J Roentgenol 191:537–545
Zho S-Y, Park J, Choi J-Y, Kim D-H (2010) Respiratory motion compensated MR cholangiopancreatography at 3.0 Tesla. J Magn Reson Imaging 32:726–732
Glockner JF, Saranathan M, Bayram E, Lee CU (2013) Breath-held MR cholangiopancreatography (MRCP) using a 3D Dixon fat-water separated balanced steady state free precession sequence. Magn Reson Imaging 31:1263–1270
Scarfe WC, Farman AG (2008) What is cone-beam CT and how does it work? Dent Clin N Am 52:707–730
Garcia JA (2013) Three-Dimensional Imaging for Coronary Interventions: Techniques and technologies for more accurate vessel views. Cardiac Interventions Today January/February
Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310
Stelter L, Freyhardt P, Grieser C et al (2014) An increased flip angle in late phase Gd-EOB-DTPA MRI shows improved performance in bile duct visualization compared to T2w-MRCP. Eur J Radiol 83:1723–1727
Kinner S, Steinweg V, Maderwald 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:e113882
Neri E, Bali MA, Ba-Ssalamah A et al (2016) ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents. Eur Radiol 26:921–931
Acknowledgments
The scientific guarantor of this publication is Kyoung Won Kim. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding from the Basic Science Research Program of the National Research Foundation of Korea, funded by the Ministry of Education, Science, and Technology (grant 2010-0021107). One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, cross sectional study, performed at one institution.
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Kim, B., Kim, K.W., Kim, S.Y. et al. Coronal 2D MR cholangiography overestimates the length of the right hepatic duct in liver transplantation donors. Eur Radiol 27, 1822–1830 (2017). https://doi.org/10.1007/s00330-016-4572-3
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DOI: https://doi.org/10.1007/s00330-016-4572-3