Additional values of high-resolution gadoxetic acid-enhanced MR cholangiography for evaluating the biliary anatomy of living liver donors: Comparison with T2-weighted MR cholangiography and conventional gadoxetic acid-enhanced MR cholangiography

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Abstract

Purpose: To determine the incremental value of small field of view (sFOV) high-resolution (HR) gadoxetic acid-enhanced 3D T1-weighted (W) magnetic resonance cholangiography (MRC) for evaluating the biliary anatomy of potential living donors by comparing it to T2W-MRC. Materials and Methods: In all, 73 living donor candidates underwent gadoxetic acid-enhanced MRI (3.0T) including three kinds of MRCs: 3D multislice T2W-MRC, regular FOV (rFOV) (380 × 380mm, resolution 1.0 × 1.2 × 3.0 mm) 3D T1W-MRC, and sFOV (256 × 208 mm, resolution 1.0 × 1.0 × 1.0 mm) HR-T1W-MRC. Three radiologists reviewed the image sets for the visibility of segmental intrahepatic bile ducts (BDs), biliary anatomy with its confidence level, and expected number of BD openings at right hemihepatectomy. Results: Compared to T2W-MRC alone, the combination of sFOV HR-T1W-MRC and T2W-MRC (sT1W-HR set) yielded significantly improved BD visibility scores (P < 0.01) and confidence levels for biliary anatomy (P < 0.01). Compared to the rT1W set (rFOV T1W-MRC with T2W MRC), the sFOV HR set showed significantly increased caudate duct visibility (P < 0.001). In the case of T2W-MRC presenting subdiagnostic image quality, the addition of sFOV HRT1W-MRC provided diagnostically acceptable image visibility (53.8∼90%) to all reviewers. The addition of sFOV HR-T1W-MRC resulted in a significantly higher consistency with the operative record and expected number of BD openings than did T2W-MRC alone (P < 0.05 in all reviewers) or rFOV set (P < 0.05 in one reviewer) with excellent interobserver agreement of both T1W-MRC sets. Conclusion: The combination of sFOV HR-T1W-MRC and T2W-MRC significantly improved BD visibility and confidence levels for biliary anatomy compared to T2W-MRC alone, thereby allowing accurate biliary anatomy assessment in most patients with subdiagnostic T2W-MRC images. Level of Evidence: 3. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2018;47:152–159.

Original languageEnglish
Pages (from-to)152-159
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume47
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • bile duct anatomy
  • high resolution TW-MRC
  • liver transplantation
  • living liver donor
  • magnetic resonance cholangiography
  • small FOV

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