Three-dimensional dynamic contrast-enhanced MR angiography for evaluating recipient vessels in orthotopic liver transplantation.
BACKGROUND
With the improvement of MR technology, three-dimensional dynamic contrast-enhanced MR angiography (3D-DCE-MRA) may be the optimal vascular imaging method for preoperative evaluation of liver transplantation candidates. This study was undertaken to determine the value of 3D-DCE-MRA in the assessment of recipient vessels in orthotopic liver transplantation (OLT).


METHODS
The surgical and pathological records were taken as the "gold standards". Eighteen cases of OLT were retrospectively analyzed to assess the image quality of MRA, including the signal-to-noise ratio (SNR) in arteries and veins, depiction of vascular variation and vessel disease, and the accuracy of vascular diameter measurement.


RESULTS
3D-DCE-MRA of 34 cases was carried out before OLT. The rates (excellent and good) showing hepatic arteries and portal vein for 3D-DCE-MRA were 94.1% (32/34) and 88.2% (30/34), respectively. The SNRs of the celiac axis and portal vein measurements from 3D-DCE-MRA were 20.58+/-3.74 and 13.43+/-4.12, and the mean diameters were 3.4+/-0.3 mm and 13.1+/-3.2 mm, respectively. There were 5 cases of vessel variation according to the Michel's classification. Of the 34 patients, 18 were compared radiologically and pathologically. The accuracy of depiction of the hepatic artery and portal vein with 3D-DCE-MRA was 100% for both; 3D-DCE-MRA precisely assessed 4 cases of more than moderate stenosis in hepatic arteries, 2 cases of small-caliber hepatic artery, 3 cases of venous stenosis at the second porta hepatis, 6 cases of collateral vasculature, 1 case of portal vein thrombosis and 1 case of portal vein aneurysm; all were confirmed pathologically.


CONCLUSIONS
3D-DCE-MRA may be the first choice for recipient vascular assessment before OLT.
Department of Radiology, Second Affiliated Hospital, Dalian Medical University, Dalian 116027, China. drbianjie@163.com
Jie
J
Bian
Lin
L
Sha
Chao
C
Yang
Chuan-Shu
CS
Sun
D001157:Arterial Occlusive Diseases / Q000473:pathology; D003251:Constriction, Pathologic; D003287:Contrast Media; D006499:Hepatic Artery / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000098:blood supply* / Q000601:surgery*; D016031:Liver Transplantation; D018810:Magnetic Resonance Angiography; D011169:Portal Vein / Q000473:pathology*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D020246:Venous Thrombosis / Q000473:pathology
D003287:Contrast Media