An Su Kyung, Lee Jeong Min, Suh Kyung-Suk, Lee Nam Jun, Kim Se Hyung, Kim Young Joon, Han Joon Koo, Choi Buyng Ihn
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
AJR Am J Roentgenol. 2006 Nov;187(5):1223-33. doi: 10.2214/AJR.05.0584.
The objective of our study was to determine whether gadobenate dimeglumine-enhanced MRI is practical as the sole preoperative imaging technique for the examination of living liver donors.
Forty-four consecutive living donor candidates underwent liver MRI on a 1.5-T MR unit. The MR examination included in- and opposed-phase T1-weighted gradient-echo imaging, T2-weighted MR cholangiography, MR angiography (MRA) and parenchymal phase imaging after the administration of gadobenate dimeglumine, and 60-minute delayed T1-weighted MR cholangiography. Two abdominal radiologists analyzed the images regarding the depiction of the biliary duct anatomy and the hepatic vascular anatomy and for the presence of focal or diffuse liver disease. The findings were compared with intraoperative cholangiographic and surgical findings in 24 patients who underwent partial hepatectomy.
In the 24 patients who underwent liver harvesting, 10 had biliary anatomic variants confirmed by intraoperative cholangiography. T2-weighted MR cholangiography allowed a correct diagnosis in 75% (n = 18/24) and T1-weighted MR cholangiography in 79% (n = 19/24) of these patients. When we evaluated the bile duct anatomy using the combined findings of T2- and T1-weighted MR cholangiographic images, the diagnostic accuracy increased to 92% (n = 22/24), but the difference was not statistically significant (p > 0.05). MRA showed a diagnostic accuracy of 79% (n = 19/24) for the hepatic arterial anatomy, 100% (n = 24/24) for the portal venous anatomy, and 96% (n = 23/24) for the hepatic venous anatomy.
Gadobenate dimeglumine-enhanced MRI allows comprehensive assessment of the biliary and hepatic vascular systems and the hepatic parenchyma and can serve as the sole preoperative imaging test for living liver donor candidates.
本研究的目的是确定钆贝葡胺增强磁共振成像（MRI）作为活体肝供体术前唯一的成像技术是否实用。
44例连续的活体供体候选者在1.5-T MR设备上进行肝脏MRI检查。MR检查包括同相位和反相位T1加权梯度回波成像、T2加权磁共振胰胆管造影（MRCP）、磁共振血管造影（MRA）以及钆贝葡胺给药后的实质期成像，还有60分钟延迟T1加权MRCP。两名腹部放射科医生分析图像，观察胆管解剖结构和肝血管解剖结构的显示情况以及是否存在局灶性或弥漫性肝脏疾病。将结果与24例行肝部分切除术患者的术中胆管造影和手术结果进行比较。
在24例进行肝脏摘取的患者中，10例术中胆管造影证实存在胆管解剖变异。T2加权MRCP对其中75%（n = 18/24）的患者做出了正确诊断，T1加权MRCP对79%（n = 19/24）的患者做出了正确诊断。当我们使用T2加权和T1加权MRCP图像的联合结果评估胆管解剖结构时，诊断准确率提高到92%（n = 22/24），但差异无统计学意义（p > 0.05）。MRA对肝动脉解剖结构的诊断准确率为79%（n = 19/24），对门静脉解剖结构的诊断准确率为100%（n = 24/24），对肝静脉解剖结构的诊断准确率为96%（n = 23/24）。
钆贝葡胺增强MRI能够对胆管和肝血管系统以及肝实质进行全面评估，可作为活体肝供体候选者术前唯一的成像检查。
