The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors.
OBJECTIVE
The purpose of this study was to investigate the ability of magnetic resonance cholangiography (MRC) in the depiction of biliary anatomy of living liver donors by using intraoperative cholangiography (IOC) as a gold standard.


METHODS
Between 2004 and 2006, 86 potential adult-to-adult living donor liver transplantation donors had preoperative MRC at our institution. Of these, 24 potential donors were excluded due to various clinical factors. A total of 62 of these individuals were selected for liver donation and included in the study. MRC was performed on a 1.5-T scanner with breath-hold, rapid acquisition with relaxation enhancement (RARE) sequence with half-Fourier acquisition (HASTE; Siemens) and free-breathing, three-dimensional turbo spin-echo sequence with respiratory triggering. Thin- and thick-slab imaging techniques were employed with half-Fourier RARE MRC. IOC was performed in all 63 cases. The images of IOC and MRC were classified according to a modified Huang classification, independently. The results of the MRC were then compared with the IOC results.


RESULTS
IOC was used as the reference standard; a total of 43 (69.3%) liver donors were considered to have normal biliary anatomy, whereas 19 (30.7%) were considered to have variants of biliary anatomy. Compared with IOC, MRC correctly revealed biliary anatomy in 59 of 62 (95.1%) donors. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 84.2%, 100%, 100%, and 93.4%, respectively.


CONCLUSIONS
MRC is an effective imaging technique for the preoperative evaluation of the biliary anatomy in living liver donors. However, MRC and IOC should be considered complementary to one another in order to avoid complications.
Sirvanci
Mustafa
M
Department of Radiology, Florence Nightingale Hospital, Istanbul, Turkey.
Duran
Cihan
C
Ozturk
Ersin
E
Balci
Deniz
D
Dayangaç
Murat
M
Onat
Levent
L
Yüzer
Yildiray
Y
Tokat
Yaman
Y
Killi
Refik
R
D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care