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Abdom Radiol (NY). 2017 Mar;42(3):842-850. doi: 10.1007/s00261-016-0936-z.

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

Author information

1
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA.
2
Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
3
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA. jane.wang@ucsf.edu.

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.

KEYWORDS:

Biliary anatomy; Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid; Living liver donors; Magnetic resonance cholangiography

PMID:
27714420
DOI:
10.1007/s00261-016-0936-z
[Indexed for MEDLINE]

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