Right lobe living donor liver transplantation: preoperative evaluation of the donor with MR imaging.
OBJECTIVE
The purpose of this study was to report our experience in preoperative evaluation of right hepatic lobe donors with a comprehensive MR examination and to compare abdominal MR images, MR cholangiograms, and MR angiograms with findings at surgery, intraoperative cholangiography, and digital subtraction angiography.


METHODS
Twenty-eight right hepatic lobe donors underwent preoperative evaluation with MR imaging, MR cholangiography, and MR angiography. Two abdominal radiologists independently and randomly reviewed these studies. Points of assessment included focal and diffuse liver disease, calculation of right lobe volumes, depiction of the biliary tract and ductal anomalies, and depiction of the liver vasculature and vascular anomalies. Comparison was made with intraoperative cholangiograms (n = 20) and digital subtraction angiograms (n = 28).


RESULTS
MR imaging revealed and characterized focal liver lesions in eight of 28 patients. Calculated right lobe volumes agreed with surgically determined volumes within 7% for reviewer 1 and within 15% for reviewer 2. Intrahepatic bile ducts were depicted completely with MR cholangiography in 25 of 28 patients and with intraoperative cholangiography in nine of 20 patients. MR cholangiography revealed ductal anomalies in six patients. MR imaging and MR angiography depicted the portal veins more completely than digital subtraction angiography. MR imaging and MR angiography correctly excluded portal venous anomalies in all patients and revealed surgically confirmed accessory hepatic veins in six of 28 patients. Angiographically confirmed arterial anomalies were correctly detected in three of 28 patients by at least one reviewer on MR imaging and MR angiography.


CONCLUSIONS
MR imaging, MR cholangiography, and MR angiography provide a comprehensive, accurate means of evaluating donors for factors that may preclude or complicate right hepatic lobe donation.
Fulcher
A S
AS
Department of Radiology, Medical College of Virginia of Virginia Commonwealth University, 401 N. 12th St., Rm. 3-407B, P. O. Box 980615, Richmond, VA 23298-0615, USA.
Szucs
R A
RA
Bassignani
M J
MJ
Marcos
A
A
D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000033:anatomy & histology; D002758:Cholangiography; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery / Q000033:anatomy & histology; D006503:Hepatic Veins / Q000033:anatomy & histology; D006801:Humans; D008099:Liver / Q000033:anatomy & histology; D016031:Liver Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D011169:Portal Vein / Q000033:anatomy & histology; D011300:Preoperative Care