Limanond Piyaporn, Raman Steven S, Ghobrial R Mark, Busuttil Ronald W, Lu David S K
Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, California 90005-1721, USA.
J Magn Reson Imaging. 2004 Feb;19(2):209-15. doi: 10.1002/jmri.10446.
To assess the utility of magnetic resonance cholangiopancreatography (MRCP) in preoperative mapping of biliary anatomy in adult-to-adult living related liver transplant (LRLT) donors.
From 57 potential donors with preoperative MRCP, 27 cases (16 men, 11 women, age range 22-51 years, mean 37.2 years) underwent right lobe resection and had intraoperative cholangiography (IOC) for comparison. The MRCP and IOC reports were retrospectively reviewed in all 27 cases. The MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2-weighted sequences in axial/coronal thin sections, and variable-thickness rotating slabs. The accuracy of preoperative MRCP for biliary mapping in potential LRLT donors was analyzed compared to the IOC findings.
Of 27 donors, 26 (96.3%) had MRCP which showed adequate information of central intrahepatic biliary anatomy. Of these, 19 had normal bifurcation confirmed by IOC, and single biliary anastomosis was created in the recipient at transplantation. MRCP correctly predicted 17 of 19 normal cases (sensitivity for normals: 89.5%). In seven donors with variant biliary anatomy, two separate biliary anastomoses were performed in the recipient. MRCP correctly predicted five of seven variants (sensitivity for variants: 71.4%). Overall, MRCP had an accuracy 84.6% (22/26).
MRCP has potential in the preoperative assessment of nondilated bile ducts in LRLT donors, however further improvements are desired to increase its quality and accuracy.
评估磁共振胰胆管造影（MRCP）在成人对成人活体肝移植（LRLT）供体术前胆道解剖结构定位中的应用价值。
对57例术前行MRCP检查的潜在供体，其中27例（男性16例，女性11例，年龄范围22 - 51岁，平均37.2岁）接受了右半肝切除术，并进行术中胆管造影（IOC）以作对比。对所有27例病例的MRCP和IOC报告进行回顾性分析。MRCP检查采用1.5特斯拉磁共振成像仪，通过屏气重T2加权序列在轴位/冠状位薄层扫描及可变厚度旋转层面成像。将术前MRCP对潜在LRLT供体胆道定位的准确性与IOC结果进行对比分析。
27例供体中，26例（96.3%）的MRCP显示了肝内中央胆道解剖结构的充分信息。其中，19例经IOC证实肝门部胆管分叉正常，移植时受体行单胆管吻合。MRCP正确预测了19例正常病例中的17例（正常情况的敏感度：89.5%）。7例胆管解剖变异的供体中，受体行双胆管吻合。MRCP正确预测了7例变异中的5例（变异情况的敏感度：71.4%）。总体而言，MRCP的准确率为84.6%（22/26）。
MRCP在LRLT供体非扩张胆管的术前评估中有潜在应用价值，但仍需进一步改进以提高其质量和准确性。
