Role of magnetic resonance cholangiography in assessing biliary anatomy in right lobe living donors.
BACKGROUND
The value of magnetic resonance cholangiography (MRC) in assessing potential adult-to-adult living liver transplant (ALDLT) donors remains poorly defined. The purpose of this study is to determine the accuracy of MRC in assessing biliary anatomy with intraoperative confirmation.


METHODS
A prospective cohort of 30 ALDLT donors who underwent right hepatectomy from October 2000 to July 2003 was evaluated. MRC was performed using a heavily T2 weighted radial slab technique. MRC was interpreted preoperatively by a radiologist and a surgeon and compared with the intraoperative biliary findings in all patients derived from cholangiography (IOC) and bile duct exploration. The sensitivity, specificity, and positive and negative predictive values of MRC for aberrant biliary anatomy were calculated.


RESULTS
MRC suggested normal, aberrant, and indeterminate biliary anatomy in 16, 12, and 2 donors, respectively. IOC revealed normal and aberrant biliary anatomy in 17 and 13 patients, respectively. MRC demonstrated biliary anatomy accurately in 27 of 30 patients. The sensitivity, specificity, positive predictive, and negative predictive values of MRC in detecting aberrant biliary anatomy were 92%, 100%, 100%, and 94%, respectively.


CONCLUSIONS
Preoperative MRC accurately depicts biliary anatomy in potential ALDLT donors and may guide the intraoperative management of the biliary tract.
Kim
Robin D
RD
MultiOrgan Transplantation Unit, Department of Surgery, University Health Network, Toronto General Hospital, University of Toronto, Ontario, Canada.
Sakamoto
Seisuke
S
Haider
Masoom A
MA
Molinari
Michele
M
Gallinger
Steven
S
McGilvray
Ian D
ID
Greig
Paul D
PD
Grant
David R
DR
Cattral
Mark S
MS
D000328:Adult; D001652:Bile Ducts / Q000033:anatomy & histology*; D049448:Cholangiopancreatography, Magnetic Resonance; D015331:Cohort Studies; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity