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Preoperative MRI of Potential Living-Donor-Related Liver Transplantation Using a Single Dose of Gadobenate Dimeglumine

¹ Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-ku Shinchondong 134, Seoul 120-752, Republic of Korea.
² Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.
³ Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.

View larger version (139K): [in a new window]   Fig. 1 —18-year-old male liver donor with replaced hepatic artery. Maximum-intensity-projection image obtained in coronal oblique plane reveals replaced common hepatic artery (arrow) arising from superior mesenteric artery.

View larger version (101K): [in a new window]   Fig. 2 —20-year-old man with middle hepatic artery arising from right hepatic artery. Three-dimensional T1-weighted gradient echo source image obtained in coronal plane shows middle hepatic artery (arrow) arising from right hepatic artery.

View larger version (158K): [in a new window]   Fig. 3 —43-year-old man with anomalous origin of right anterior segmental branch from left portal vein. Maximum-intensity-projection image shows anomalous origin of right anterior segmental branch (long arrow) from left portal vein. Right posterior portal vein branch arises more proximally (short arrow).

View larger version (132K): [in a new window]   Fig. 4A —20-year-old man with large right inferior accessory hepatic vein. Balanced turbo field-echo images (A = axial image; B = coronal image) reveal a 7.3-mm right inferior accessory hepatic vein (arrow) entering inferior vena cava.

View larger version (141K): [in a new window]   Fig. 4B —20-year-old man with large right inferior accessory hepatic vein. Balanced turbo field-echo images (A = axial image; B = coronal image) reveal a 7.3-mm right inferior accessory hepatic vein (arrow) entering inferior vena cava.

View larger version (86K): [in a new window]   Fig. 5A —40-year-old man with ductal trifurcation. T2-weighted single-shot fast spin-echo MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A) was interpreted as ductal trifurcation with low diagnostic confidence grades by both reviewers, but serial-enhanced T1-weighted MR cholangiography (coronal 3D T1-weighted gradient-echo MRI [TR/TE, 5.1/1.47; flip angle, 40°]) (B) accurately depicts trifurcation pattern (right anterior segmental branch: long black arrow, left hepatic duct: short black arrow, right posterior segmental branch: white arrows) (anterior to posterior).

View larger version (139K): [in a new window]   Fig. 5B —40-year-old man with ductal trifurcation. T2-weighted single-shot fast spin-echo MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A) was interpreted as ductal trifurcation with low diagnostic confidence grades by both reviewers, but serial-enhanced T1-weighted MR cholangiography (coronal 3D T1-weighted gradient-echo MRI [TR/TE, 5.1/1.47; flip angle, 40°]) (B) accurately depicts trifurcation pattern (right anterior segmental branch: long black arrow, left hepatic duct: short black arrow, right posterior segmental branch: white arrows) (anterior to posterior).

View larger version (77K): [in a new window]   Fig. 6A —40-year-old woman with right posterior segmental duct draining into left hepatic duct. T2-weighted single-shot fast spin-echo MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A). T1-weighted coronal-enhanced MR cholangiography serial images from anterior to posterior (TR/TE, 5.1/1.47; flip angle, 40°) (B) and intraoperative cholangiogram image (C) accurately shows right posterior segmental duct (short white arrow) draining aberrantly into proximal left hepatic duct (black arrow). Right anterior segmental duct is also well-depicted (long white arrow).

View larger version (141K): [in a new window]   Fig. 6B —40-year-old woman with right posterior segmental duct draining into left hepatic duct. T2-weighted single-shot fast spin-echo MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A). T1-weighted coronal-enhanced MR cholangiography serial images from anterior to posterior (TR/TE, 5.1/1.47; flip angle, 40°) (B) and intraoperative cholangiogram image (C) accurately shows right posterior segmental duct (short white arrow) draining aberrantly into proximal left hepatic duct (black arrow). Right anterior segmental duct is also well-depicted (long white arrow).

View larger version (109K): [in a new window]   Fig. 6C —40-year-old woman with right posterior segmental duct draining into left hepatic duct. T2-weighted single-shot fast spin-echo MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A). T1-weighted coronal-enhanced MR cholangiography serial images from anterior to posterior (TR/TE, 5.1/1.47; flip angle, 40°) (B) and intraoperative cholangiogram image (C) accurately shows right posterior segmental duct (short white arrow) draining aberrantly into proximal left hepatic duct (black arrow). Right anterior segmental duct is also well-depicted (long white arrow).

View larger version (84K): [in a new window]   Fig. 7A —27-year-old male liver donor with short right hepatic duct. T2-weighted MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A) shows biliary anatomy closely resembling trifurcation pattern. Reviewer 1 interpreted this case as trifurcation pattern. However, gadobenate dimeglumine-enhanced MR cholangiography (TR/TE, 5.1/1.47; flip angle, 40°) (B) shows short right hepatic duct (white arrow) (anterior to posterior). Intraoperative cholangiogram (C) confirmed finding on enhanced T1-weighted MR cholangiography. Single orifice was obtained while harvesting right lobe.

View larger version (134K): [in a new window]   Fig. 7B —27-year-old male liver donor with short right hepatic duct. T2-weighted MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A) shows biliary anatomy closely resembling trifurcation pattern. Reviewer 1 interpreted this case as trifurcation pattern. However, gadobenate dimeglumine-enhanced MR cholangiography (TR/TE, 5.1/1.47; flip angle, 40°) (B) shows short right hepatic duct (white arrow) (anterior to posterior). Intraoperative cholangiogram (C) confirmed finding on enhanced T1-weighted MR cholangiography. Single orifice was obtained while harvesting right lobe.

View larger version (113K): [in a new window]   Fig. 7C —27-year-old male liver donor with short right hepatic duct. T2-weighted MR cholangiography (TR/TE, /1,088 [effective], 30-mm thickness) (A) shows biliary anatomy closely resembling trifurcation pattern. Reviewer 1 interpreted this case as trifurcation pattern. However, gadobenate dimeglumine-enhanced MR cholangiography (TR/TE, 5.1/1.47; flip angle, 40°) (B) shows short right hepatic duct (white arrow) (anterior to posterior). Intraoperative cholangiogram (C) confirmed finding on enhanced T1-weighted MR cholangiography. Single orifice was obtained while harvesting right lobe.

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