title: Determinants of second-order bile duct visualization at CT cholangiography in potential living liver donors.
abstract: OBJECTIVE
  The purpose of this article is to investigate the determinants of second-order bile duct visualization at CT cholangiography in living potential liver donors.
  
  
  METHODS
  We retrospectively identified 143 potential living liver donors (83 men and 60 women; mean age, 37 years) evaluated with CT cholangiography, which included a slow infusion of iodipamide meglumine with CT acquisition 15 minutes after biliary contrast agent administration. Two readers independently scored the visualization of the second-order bile duct branches on a previously established 4-point scale (0 = not seen, 1 = faintly seen, 2 = well seen, and 3 = excellent visualization). Multivariate analysis was used to investigate the correlation between visualization scores and potential determinants of second-order bile duct opacification, specifically age, body mass index, creatinine level, total and direct bilirubin levels, alkaline phosphatase level, aspartate aminotransferase level, alanine aminotransferase level, patient maximum linear width, CT noise, and hepatosplenic attenuation difference at unenhanced CT.
  
  
  RESULTS
  The mean (± SD) second-order bile duct visualization scores were 2.35 ± 0.66 and 2.55 ± 0.60 for readers 1 and 2, respectively. In the multivariate analysis, the only independent predictors of reduced second-order bile duct visualization were higher alkaline phosphatase level (p = 0.01) and higher CT noise (p = 0.02).
  
  
  CONCLUSIONS
  Higher serum alkaline phosphatase level and higher CT noise in potential living liver donors indicate a higher risk of poor second-order bile duct visualization at CT cholangiography.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143-0628, USA.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Keedy
authors.forename: Richard S
authors.initials: RS
authors.lastname: Breiman
authors.forename: Emily M
authors.initials: EM
authors.lastname: Webb
authors.forename: John P
authors.initials: JP
authors.lastname: Roberts
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Coakley
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
mesh_terms: D000293:Adolescent; D000328:Adult; D001652:Bile Ducts / Q000002:abnormalities*; D002758:Cholangiography; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*