Abstract:
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Purpose: Evaluate the ability of MR imaging to detect clinically significant aberrant anatomy in the biliary tract, hepatic venous and arterial system, and portal venous system, as well as determination of liver volume in preoperative analysis of potential donors for living donor liver transplantation (LDLT)
Methods and Materials: Between July 1999 and July 2002, 25 potential donors underwent evaluation for LDLT with MRI of the liver, MR angiography, and MR cholangiopancreatography. 13 patients subsequently underwent donor right lobectomies. Preoperative imaging findings are correlated with intra-operative surgical and intra-operative cholangiography findings as well as intra-operative weight determination of the right lobe.
Results: There is complete concordance between MR imaging findings and intra-operative findings for the hepatic arterial and venous anatomy (13/13). In particular, all accessory hepatic veins greater than 5 mm noted during imaging were identified at surgery and anastomosed to the recipient's IVC. For the portal venous system, there was only one instance of discordance (12/13) between imaging and operative findings. Trifurcation of the portal vein was detected at imaging, however, intra-operatively, the surgeon was able to create a single cuff for anastomosis and thus clinically the anatomy was normal. With respect to the biliary system, two patients could not have adequate evaluation due to technical limitations of the MRCP images. Among the remaining eleven patients, only one episode of discordance occurred, where a right posterior hepatic duct arising from the common hepatic duct was not detected (total 10/13). Calculated right hepatic lobe volumes were within acceptable range of weighed grafts at the time of surgery.
Conclusion: MR imaging of the liver in combination with MR angiography and MR cholangiopancreatography is an accurate, non-invasive modality for pre-operative evaluation of potential donors for living donor liver transplantation.
Questions about this event email: khosseinzadeh@umm.edu
Filigenzi MD, J,
Correlation of MR Imaging with Surgical Findings in Preoperative Evaluation of Living Donor Liver Transplantation. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3104960.html
