title: Magnetic resonance of the hepatic veins with angular reconstruction: application in living-related liver transplantation.
abstract: BACKGROUND
  Preoperative mapping of the hepatic venous system of the partial liver graft is indispensable to the success of living-related liver transplantation. We assessed the accuracy of magnetic resonance (MR) venography with angular reconstruction in depicting the tributaries of the middle hepatic vein and left hepatic vein in the donors, which was essential in graft retrieval and venoplasty.
  
  
  METHODS
  Nineteen living-related liver transplantation donors underwent a pretransplantation survey, including sonography and MRI for hepatic venous evaluation. T1-weighted images were reconstructed manually, using the inferior vena cava as a fixed point for tilting to produce an oblique plane image where both the middle hepatic vein and left hepatic vein could be demonstrated draining into the inferior vena cava. The reconstructed images of the hepatic veins were compared with preoperative sonography, intraoperative sonography, and operative findings.
  
  
  RESULTS
  Preoperative sonography and MR findings correlated well with the operative findings in the major hepatic veins. The MR venography of the ramification of the hepatic veins has an accuracy of 93%, the sonography, 84%. Sonography is slightly inferior in the evaluation of the hepatic vein in segment 4 and the left superior hepatic vein, with an accuracy of 73% and 67%, respectively.
  
  
  CONCLUSIONS
  MR venography with angular reconstruction is accurate in depicting the complex distribution of the hepatic veins of the left liver, providing important information for decision making as to the cutting plane during graft retrieval and the method of venoplasty and anastomosis. Thus, unnecessary blood loss could be avoided and vascular complications could be prevented, as these conditions would be unacceptable for a healthy living donor. We propose that MR venography, a rapid and reliable technique, is an appropriate alternative examination or complementary modality to sonography in the pretransplantation evaluation of the living donor.
authors.affiliation: Department of Diagnostic Radiology, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. f6591@ms4.hinet.net
authors.forename: Y F
authors.initials: YF
authors.lastname: Cheng
authors.forename: C L
authors.initials: CL
authors.lastname: Chen
authors.forename: T L
authors.initials: TL
authors.lastname: Huang
authors.forename: T Y
authors.initials: TY
authors.lastname: Chen
authors.forename: T Y
authors.initials: TY
authors.lastname: Lee
authors.forename: Y S
authors.initials: YS
authors.lastname: Chen
authors.forename: C C
authors.initials: CC
authors.lastname: Wang
authors.forename: V
authors.initials: V
authors.lastname: de Villa
authors.forename: S
authors.initials: S
authors.lastname: Goto
authors.forename: Y C
authors.initials: YC
authors.lastname: Chiang
authors.forename: H L
authors.initials: HL
authors.lastname: Eng
authors.forename: B
authors.initials: B
authors.lastname: Jawan
authors.forename: H K
authors.initials: HK
authors.lastname: Cheung
mesh_terms: D000328:Adult; D005260:Female; D006503:Hepatic Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008297:Male; D011859:Radiography; D014463:Ultrasonography