MR cholangiopancreatography with T2-weighted prospective acquisition correction turbo spin-echo sequence of the biliary anatomy of potential living liver transplant donors.
OBJECTIVE
The objective of our study was to evaluate the ability of a respiratory navigator-triggered T2-weighted turbo spin-echo (TSE) sequence with a prospective acquisition correction (PACE) technique for MR cholangiopancreatography (MRCP) to depict the biliary anatomy of living donor liver transplantation (LDLT) donors.


METHODS
Forty potential LDLT donors who ranged in age from 19 to 54 years were prospectively evaluated with preoperative MRCP. MRCP was performed with a 1.5-T magnetic field using T2-weighted PACE TSE sequence. MRCP source data sets were processed with maximum-intensity-projection (MIP) and shaded surface display (SSD) algorithms. Findings were compared with intraoperative cholangiography. Biliary anatomy was classified according to the classification proposed by Huang and colleagues. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRCP for the detection of aberrant biliary anatomy were calculated.


RESULTS
Intraoperative cholangiography and biliary exploration revealed that 27 donor candidates (67.5%) had conventional and 13 (32.5%) had aberrant biliary anatomy. Two donors (5%) had type B biliary anatomy; eight donors (20%), type C; two donors (5%), type D; and one donor (2.5%), unclassified. The sensitivity of MRCP source data sets in differentiating aberrant biliary anatomies from nonaberrant ones was 100%, the specificity was 88.9%, and the accuracy was 92.5%. PPV and NPV were 81.3% and 100%, respectively. The sensitivity of MIP images in differentiating aberrant biliary anatomies was 100%, the specificity was 88.9%, and the accuracy was 92.5%. PPV and NPV were 81.3% and 100%, respectively. The sensitivity, specificity, accuracy, PPV, and NPV of the SSD images in detecting aberrant biliary anatomies were 100%, 77.8%, 85%, 68.4%, and 100%, respectively.


CONCLUSIONS
Preoperative MRCP using a respiratory navigator-triggered T2-weighted TSE sequence with a PACE technique accurately depicts the biliary anatomy in LDLT donors and may guide intraoperative management of the biliary tract.
Basaran
Ceyla
C
Department of Radiodiagnostic, Baskent University Faculty of Medicine, Fevzi Cakmak caddesi 10.sokak, No: 45, 06490 Bahçelievler, Ankara, Turkey. ceylab@baskent-ank.edu.tr
Agildere
A Muhtesem
AM
Donmez
Fuldem Yildirim
FY
Sevmis
Sinasi
S
Budakoglu
Irem
I
Karakayali
Hamdi
H
Haberal
Mehmet
M
D000328:Adult; D001659:Biliary Tract / Q000000981:diagnostic imaging*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D016031:Liver Transplantation / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011859:Radiography