title: Preoperative imaging evaluation of the hepatic vasculature in biliary atresia patients undergoing LDLT: comparison of MDCT and MRI.
abstract: LT is the definitive treatment option in the management of end-stage liver disease. Preoperative vascular evaluation plays an important role for a safe and successful operation in LDLT. The purpose of this study is to assess the usefulness and accuracy of CTA and MRA in evaluating vascular anomalies in BA patients undergoing LDLT. Images of CTA and MRA for preoperative vascular evaluation in 57 BA patients undergoing LDLT were reviewed with the operative and pathologic findings. All underwent preoperative CTA and MRA. Pathologic PV (n = 20), interruption of the retro-hepatic vena cava (n = 1), aberrant right HA from the SMA (n = 2) were confirmed during the transplant operation. The success rate of CTA and MRA in identifying vascular anomalies was 96% and 82%, respectively (p = 0.01). The IQR scores were 3.25 +/- 0.53 for CTA and 2.91 +/- 0.70 for MRA (p = 0.001). The sensitivity, specificity and accuracy of CTA were 85%, 97% and 93%, respectively; and for MRA, were 65%, 95% and 84%, respectively. CTA is superior than MRA in the preoperative evaluation of the vascular anatomy in pediatric BA LDLT candidates.
authors.affiliation: Liver Transplantation Program and Department of Diagnostic Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, and Chang Gung University College of Medicine, Taiwan.
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Yu
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Tung-Liang
authors.initials: TL
authors.lastname: Huang
authors.forename: Tai-Yi
authors.initials: TY
authors.lastname: Chen
authors.forename: Leo Leung-Chit
authors.initials: LL
authors.lastname: Tsang
authors.forename: Hsin-You
authors.initials: HY
authors.lastname: Ou
authors.forename: Allan M
authors.initials: AM
authors.lastname: Concejero
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Shih-Ho
authors.initials: SH
authors.lastname: Wang
authors.forename: Yu-Fan
authors.initials: YF
authors.lastname: Cheng
mesh_terms: D001656:Biliary Atresia / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D016031:Liver Transplantation; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D019786:Gadolinium DTPA; C054871:ioversol