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MR Cholangiography for Evaluation of Hilar Branching Anatomy in Transplantation of the Right Hepatic Lobe from a Living Donor

¹ Department of Diagnostic Radiology, Yonsei University Health System, 134 Shinchon-dong, Seodaemoon-ku, Seoul 120-752, Republic of Korea.
² Institute of Gastroenterology, Yonsei University Health System, Seoul, Republic of Korea.
³ Department of Biostatistics, Yonsei University Health System, Seoul, Republic of Korea.
⁴ Department of Surgery, Yonsei University Health System, Seoul, Republic of Korea.

OBJECTIVE. Our objective was to determine the utility of 3D T2 MR cholangiography (MRC) for biliary visualization and predicting the number of ductal orifices during right lobe harvesting for ductal anastomosis in liver donors for right lobe transplantation.

MATERIALS AND METHODS. This study was composed of 33 donors who underwent right lobectomy for transplantation. Preoperative MRC techniques included 2D T2 MRC, 3D T2 MRC, and 3D contrast-enhanced T1 MRC. Qualitative analyses were performed for ductal visualization in each technique. The accuracies for predicting the numbers of orifices during right lobe harvesting were evaluated for 2D T2 MRC alone and for various other combined sets. MRI definitions of the predicted number of ductal orifices were compared with surgical findings.

RESULTS. Mean visualization scores of all ducts for 3D T2 MRC were significantly higher than for 2D T2 MRC and 3D contrast-enhanced T1 MRC. In predicting the number of orifices, all combined sets showed significantly higher accuracy than 2D T2 MRC. No significant difference in mean accuracies was observed within the comparison of the combined sets.

CONCLUSION. Three-dimensional T2 MRC provided superior biliary visualization than 2D T2 MRC and 3D contrast-enhanced T1 MRC. For predicting the number of orifices, the combined set of 2D and 3D T2 MRC enabled better accuracy than 2D T2 MRC alone and produced comparable results to other combined sets.

Keywords: anatomy • bile ducts • liver transplantation • MR cholangiopancreatography

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