Preoperative MRI of potential living-donor-related liver transplantation using a single dose of gadobenate dimeglumine.
OBJECTIVE
This article evaluates the feasibility of single-dose gadobenate dimeglumine-enhanced MRI as both an angiographic and biliary contrast medium for making a preoperative evaluation of the donor candidates for a living-donor-related liver transplantation.


METHODS
Eleven right hepatic lobe donors underwent MRI examinations using T1- and T2-weighted imaging and T2-weighted MR cholangiography (MRC). The MR angiography (MRA) and contrast-enhanced (CE) T1-weighted MRC images then were obtained after injecting a single dose of gadobenate dimeglumine. One radiologist and one surgeon prospectively reviewed all the MRI examinations for hepatic vascular and biliary abnormalities and compared them with the surgical findings and intraoperative cholangiograms. In addition, two blinded reviewers evaluated the two sets of MRC (T2-weighted MRC set and T2-weighted MRC plus CE-T1-weighted MRC set) retrospectively and recorded the anatomic types of the hilar biliary branching pattern along with their confidence in the interpretation.


RESULTS
Prospective analysis detected the following vascular variants: hepatic arterial variation in two patients, portal venous variation in one, and a significantly large accessory hepatic vein (> 5 mm) in one. Biliary variants also were identified in two patients. All the MRI findings on the vascular and biliary anatomy were corroborated intraoperatively. Retrospective analysis showed that the mean diagnostic confidence in the combined set was significantly higher than that of the T2-weighted MRC alone by both reviewers (p < 0.05).


CONCLUSIONS
Obtaining both MRA and CE-T1-weighted MRC is feasible using a single dose of gadobenate dimeglumine. Therefore, gadobenate dimeglumine-enhanced MRI might play a role as a preoperative imaging technique for the vascular and biliary evaluation of potential living donors.
Lim
Joon Seok
JS
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-ku Shinchondong 134, Seoul 120-752, Republic of Korea.
Kim
Myeong-Jin
MJ
Kim
Joo Hee
JH
Kim
Soon Il
SI
Choi
Jin-Sub
JS
Park
Mi-Suk
MS
Oh
Young Taik
YT
Yoo
Hyung Sik
HS
Lee
Jong Tae
JT
Kim
Ki Whang
KW
D000293:Adolescent; D000328:Adult; D001652:Bile Ducts / Q000033:anatomy & histology; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium; D006499:Hepatic Artery / Q000033:anatomy & histology; D006503:Hepatic Veins / Q000033:anatomy & histology; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply; D016031:Liver Transplantation; D019520:Living Donors; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D011169:Portal Vein / Q000033:anatomy & histology
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D005682:Gadolinium