학술논문

Evaluation of biliary ductal anatomy in potential living liver donors: comparison between MRCP and Gd-EOB-DTPA-enhanced MRI.
Document Type
Article
Source
Abdominal Radiology. Oct2017, Vol. 42 Issue 10, p2428-2435. 8p. 2 Color Photographs, 1 Diagram, 4 Charts.
Subject
*BILE ducts
*ORGAN donation
*LIVER transplantation
*MAGNETIC resonance imaging
*RADIOLOGY
*ANATOMY
Language
ISSN
2366-004X
Abstract
Purpose: To compare magnetic resonance cholangiopancreatography (MRCP) and Gd-EOB-DTPA-enhanced MRI in the evaluation of the biliary anatomy in potential living liver donors (LLDs). Methods: A retrospective study was conducted in a tertiary care liver transplant center after obtaining ethics and institutional approvals. A total of 42 potential LLD MRI examinations were performed between November 2013 and March 2016. All patients underwent a standard MRI protocol which included MRCP and Gd-EOB-DTPA-enhanced MRI sequences in a single session. Three abdominal MR radiologists independently reviewed the studies and completed a customized data collection sheet for each MR sequence. The readers subjectively scored the bile duct visualization on each MR sequence on a Likert scale and classified the biliary anatomic configuration. Statistical analysis was performed using intraclass correlation coefficient and the McNemar Chi-square ( χ ) test. Results: The 42 potential LLDs included 22 males and 20 females with an age range of 18-60 years. There was 'good' or 'excellent' inter-reader agreement on either MRI examination for the visualization of the first- and second-order ducts and the majority of third-order ducts. 'Good' inter-reader agreement on Gd-EOB-DTPA-enhanced MRI and 'fair' inter-reader agreement on MRCP was noted for the left third-order medial duct. There was significantly better visualization of the cystic duct, left hepatic duct, and right second-order ducts on Gd-EOB-DTPA-enhanced MRI compared with MRCP. A 12.6% improvement in classifying the biliary branch pattern was also observed on Gd-EOB-DTPA-enhanced MRI compared with MRCP ( P = 0.03). Conclusion: Gd-EOB-DTPA-enhanced MRI provides additional diagnostic confidence over MRCP in the evaluation of the biliary ductal anatomy in potential LLDs. [ABSTRACT FROM AUTHOR]