title: 3D T2-weighted and Gd-EOB-DTPA-enhanced 3D T1-weighted MR cholangiography for evaluation of biliary anatomy in living liver donors.
abstract: To investigate whether the addition of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced 3D T1-weighted MR cholangiography (T1w-MRC) to 3D T2-weighted MRC (T2w-MRC) improves the confidence and diagnostic accuracy of biliary anatomy in living liver donors.
  
  
  
  Two abdominal radiologists retrospectively and independently reviewed pre-operative MR studies in 58 consecutive living liver donors. The second-order bile duct visualization on T1w- and T2w-MRC images was rated on a 4-point scale. The readers also independently recorded the biliary anatomy and their diagnostic confidence using (1) combined T1w- and T2w-MRC, and (2) T2w-MRC. In the 23 right lobe donors, the biliary anatomy at imaging and the imaging-predicted number of duct orifices at surgery were compared to intra-operative findings.
  
  
  
  T1w-MRC had a higher proportion of excellent visualization than T2w-MRC, 66% vs. 45% for reader 1 and 60% vs. 31% for reader 2. The median confidence score for biliary anatomy diagnosis was significantly higher with combined T1w- and T2w-MRC than T2w-MRC alone for both readers (Reader 1: 3 vs. 2, p < 0.001; Reader 2: 3 vs. 1, p < 0.001). Compared to intra-operative findings, the accuracy of imaging-predicted number of duct orifices using combined T1w-and T2w-MRC was significantly higher than that using T2w-MRC alone (p = 0.034 for reader 1, p = 0.0082 for reader 2).
  
  
  
  The addition of Gd-EOB-DTPA-enhanced 3D T1w-MRC to 3D T2w-MRC improves second-order bile duct visualization and increases the confidence in biliary anatomy diagnosis and the accuracy in the imaging-predicted number of duct orifices acquired during right lobe harvesting.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Cai
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Westphalen
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Roberts
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA. jane.wang@ucsf.edu.
authors.forename: Zhen J
authors.initials: ZJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Biliary anatomy; Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid; Living liver donors; Magnetic resonance cholangiography