Preoperative evaluation of patients awaiting liver transplantation: comparison of multiphasic contrast-enhanced 3D magnetic resonance to helical computed tomography examinations.
OBJECTIVE
To determine the feasibility of using a multiphasic magnetic resonance (MR) examination to evaluate the hepatic arterial anatomy and parenchyma in patients awaiting orthotopic liver transplantation (OLT).


METHODS
Twenty consecutive patients awaiting OLT underwent multiphasic MR (using a T1-weighted 3D gadolinium-enhanced gradient-echo (GRE) sequence and two separate injections of contrast material) and computed tomography (CT) imaging; both imaging studies were performed within a 1-week period for each patient. Quantitative and qualitative assessment of the hepatic arterial system on MR data was performed. Two independent observers classified the hepatic arterial anatomy and evaluated the hepatic parenchyma from the MR data. The prospective CT interpretation was used as the gold standard.


RESULTS
Overall qualitative rating of hepatic arterial system-to-background contrast on MR data was good to excellent (average pooled score of 2.00 +/- 0.27), with no significant difference between the two observers after the first or second injections of contrast material. Classification of hepatic arterial anatomy by MR angiography (MRA) and CT angiography (CTA) was concordant in 85% (17/20) of patients and discordant in 15% (3/20) of patients. Focal parenchymal lesions were detected in 25% (5/20) of patients by MR and CT; however, two lesions in one patient with multiple lesions were detected only with MR.


CONCLUSIONS
Multiphasic T1-weighted 3D gadolinium-enhanced MR examination can provide comprehensive evaluation of the hepatic arterial anatomy and parenchyma in patients awaiting OLT. MR may offer an advantage over CT in the detection of focal parenchymal lesions.
Eubank
William B
WB
Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA. weubank@u.washington.edu
Wherry
Kimberly L
KL
Maki
Jeff H
JH
Sahin
Hakan
H
Funkhouser
Charles P
CP
Schmiedl
Udo P
UP
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D036542:Tomography, Spiral Computed
D003287:Contrast Media