Concordance of second-order portal venous and biliary tract anatomies on MDCT angiography and MDCT cholangiography.
OBJECTIVE
We sought to investigate the concordance between second-order portal venous and biliary tract anatomies using MDCT angiography and MDCT cholangiography.


METHODS
We retrospectively identified 56 living related potential liver donors who underwent both MDCT angiography and MDCT cholangiography. Two reviewers independently rated axial images and 3D reconstructions of MDCT angiograms and cholangiograms as diagnostic or nondiagnostic with respect to depiction of second-order portal venous and biliary tract anatomies. In images rated as diagnostic, second-order portal venous and biliary tract anatomies were categorized as conventional or variant. The concordance between portal venous and biliary tract anatomies was analyzed using McNemar exact chi-square test.


RESULTS
All examinations were diagnostic. Second-order portal venous variants were seen in 10 (18%) and biliary branch variants were seen in 23 (41%) of the 56 patients. Patients with variant portal venous anatomy (6/10, 60%) were more likely to have variant biliary tract anatomy than patients with conventional portal venous anatomy (17/46, 37%; p < 0.01). The sensitivity of variant portal venous anatomy as a marker for variant biliary anatomy was 26% (6/23 patients).


CONCLUSIONS
Concordance between second-order portal venous and biliary tract anatomies is statistically significant. However, in our series, a number of patients with conventional portal venous anatomy had variant biliary anatomy; therefore, the finding of conventional portal venous anatomy does not obviate preoperative biliary tract imaging in patients before liver donation.
Chen
James S
JS
Abdominal Imaging, Department of Radiology, University of California, San Francisco, Box 0628, C-324C, 505 Parnassus Ave., San Francisco, CA 94143-0628, USA.
Yeh
Benjamin M
BM
Wang
Zhen J
ZJ
Roberts
John P
JP
Breiman
Richard S
RS
Qayyum
Aliya
A
Coakley
Fergus V
FV
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001659:Biliary Tract / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D002758:Cholangiography; D003287:Contrast Media; D005260:Female; D006801:Humans; D007458:Iodipamide; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007458:Iodipamide