Abstract
Background: Since the advent of a new generation of inflow-sensitive inversion recovery (IFIR) technology, three-dimensional non-contrast-enhanced magnetic resonance angiography is being used to obtain hepatic vessel images without applying gadolinium contrast agent. The purpose of this study was to explore the diagnostic efficacy of non-contrast-enhanced magnetic resonance angiography (non-CE MRA), contrast-enhanced magnetic resonance angiography (CMRA), and computed tomography angiography (CTA) in the preoperative evaluation of living liver donors. Methods: A total of 43 liver donor candidates who were evaluated for living donor liver transplantation completed examinations. Donors’ age, gender, renal function (eGFR), and previous CTA and imaging were recorded before non-CE MRA and CMRA. CTA images were used as the standard. Results: Five different classifications of hepatic artery patterns (types I, III, V, VI, VIII) and three different classifications of portal vein patterns (types I, II, and III) were identified among 43 candidates. The pretransplant vascular anatomy was well identified using combined non-CE MRA and CMRA of hepatic arteries (100%), PVs (98%), and hepatic veins (100%) compared with CTA images. Non-CE MRA images had significantly stronger contrast signal intensity of portal veins (p < 0.01) and hepatic veins (p < 0.01) than CMRA. No differences were found in signal intensity of the hepatic artery between non-CE MRA and CMRA. Conclusion: Combined non-CE MRA and CMRA demonstrate comparable diagnostic ability to CTA and provide enhanced biliary anatomy information that assures optimum donor safety.
Highlights
All hepatic vasculatures were clearly delineated in the computed tomography angiography (CTA) study, including the origin of S4HA, either in the multiplanar reconstructed image or maximum intensity projection (MIP) reconstructed image
Results of the present study show that the pretransplant vascular anatomy can be well identified using combined non-CE MRA and contrast-enhanced magnetic resonance angiography (CMRA) of the hepatic arteries (100%), PVs
The present study has shown the optimal diagnostic performance of non-CE MRA and CMRA with results comparable to those of standard
Summary
Computed tomographic angiography (CTA) is a rapid and accurate method by which to delineate vascular anatomy and liver parenchymal lesions [4]. It replaces conventional digital subtraction angiography, which requires an invasive procedure and is no longer performed routinely, making it a reliable imaging modality for vascular anatomy surveys. Contrast-enhanced MR angiography (CMRA) has been applied in the preoperative evaluation of LDLT. Both CTA and CMRA demonstrate agreement and complete information regarding the hepatic vasculature [5]. The purpose of this study was to explore the diagnostic efficacy of non-contrast-enhanced magnetic resonance angiography (non-CE MRA), contrast-enhanced magnetic resonance angiography (CMRA), and computed tomography angiography (CTA) in the preoperative evaluation of living liver donors
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