Preoperative evaluation of biliary anatomy of donor in living donor liver transplantation by conventional nonenhanced magnetic resonance cholangiography.
Detailed preoperative evaluation of the biliary anatomy of the donor in living donor liver transplantation (LDLT) can minimize postoperative morbidity in the recipient and maximize safety for the donor. We prospectively evaluated the diagnostic accuracy and clinical usefulness of nonenhanced conventional magnetic resonance cholangiography (MRC) for depicting the biliary anatomy of LDLT donors. MRC and intraoperative cholangiography (IOC) examinations of 111 donors were performed between August 2005 and February 2006. We observed the classical branching pattern of the biliary system in 67 subjects (60.4%), with the remaining 44 subjects (39.6%) showing anatomical variations. MRC showed accurate anatomy of the biliary system, using IOC as the reference standard, in 98 (88.3%) subjects. MRC had a sensitivity in differentiating normal from variant anatomy of 95.5%, specificity of 95.2%, a positive predictive value of 96.8% and a negative predictive value of 93.3%. The agreement between MRC and IOC findings, as evaluated by kappa-value (0.865) was statistically significant (P<0.001). In conclusion, the diagnostic accuracy of conventional nonenhanced MRC is sufficient for this method to be used for the preoperative evaluation of biliary anatomy in LDLT donor candidates.
Song
Gi-Won
GW
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Lee
Sung-Gyu
SG
Hwang
Shin
S
Sung
Gyu-Bo
GB
Park
Kwang-Min
KM
Kim
Ki-Hun
KH
Ahn
Chul-Soo
CS
Moon
Deok-Bog
DB
Ha
Tae-Yong
TY
Kim
Bum-Soo
BS
Moon
Ki-Myung
KM
Jung
Dong-Hwan
DH
D000293:Adolescent; D000328:Adult; D001659:Biliary Tract / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods*; D046148:Donor Selection; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies