title: Magnetic resonance cholangiography in living donor liver transplantation.
abstract: OBJECTIVE
  Exact knowledge of biliary anatomy is essential in living donor liver transplantation. The purpose of this study was to evaluate the accuracy of pretransplant magnetic resonance cholangiography (MRC) in depicting the biliary anatomy in comparison with intraoperative cholangiography (IOC).
  
  
  METHODS
  From May 2006 to July 2009, 451 potential living liver donors underwent pretransplant evaluation at the Chang Gung Memorial Hospital-Kaohsiung Medical Center. Two hundred thirty-three donors underwent donor hepatectomy. Of these, only 203 donors with both preoperative MRC and IOC were included in this study.
  
  
  RESULTS
  Of the 451 potential donors, 218 (48.3%) were considered unsuitable for liver donation, hence was immediately disqualified after the initial evaluation for various reasons. Six of the 218 unsuitable donors (2.8%) were excluded due to complicated biliary anatomy. The overall accuracy rate of MRC for defining the biliary anatomy was 91.6%, with 84.9% sensitivity, 96% specificity, 88.2% positive predictive value, and 94.7% negative predictive value. There were 14 misidentified cases. The errors in MRC reading was largely attributed to the poor contrast between the biliary ducts and the surrounding tissues and organs. The concurrence between MRC and IOC were commendable (κ=0.9). No significant biliary complications were noted in the mismatch group.
  
  
  CONCLUSIONS
  MRC is essential for all pretransplantation evaluation with 91.6% accuracy rate.
authors.affiliation: Department of Diagnostic Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Hsien-Wen
authors.initials: HW
authors.lastname: Hsu
authors.forename: Leo Leung-Chit
authors.initials: LL
authors.lastname: Tsang
authors.forename: Anthony
authors.initials: A
authors.lastname: Yap
authors.forename: Tung-Liang
authors.initials: TL
authors.lastname: Huang
authors.forename: Tai-Yi
authors.initials: TY
authors.lastname: Chen
authors.forename: Tsan-Shiun
authors.initials: TS
authors.lastname: Lin
authors.forename: Allan M
authors.initials: AM
authors.lastname: Concejero
authors.forename: Shin-You
authors.initials: SY
authors.lastname: Ou
authors.forename: Chun-Yen
authors.initials: CY
authors.lastname: Yu
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.forename: Yu-Fan
authors.initials: YF
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000328:Adult; D001659:Biliary Tract / Q000033:anatomy & histology*; D002758:Cholangiography; D049448:Cholangiopancreatography, Magnetic Resonance; D046148:Donor Selection / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007432:Intraoperative Period; D016031:Liver Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D020858:Tissue and Organ Harvesting / Q000379:methods; D055815:Young Adult