Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143-0628, USA.
AJR Am J Roentgenol. 2013 May;200(5):1028-33. doi: 10.2214/AJR.11.8364.
The purpose of this article is to investigate the determinants of second-order bile duct visualization at CT cholangiography in living potential liver donors.
We retrospectively identified 143 potential living liver donors (83 men and 60 women; mean age, 37 years) evaluated with CT cholangiography, which included a slow infusion of iodipamide meglumine with CT acquisition 15 minutes after biliary contrast agent administration. Two readers independently scored the visualization of the second-order bile duct branches on a previously established 4-point scale (0 = not seen, 1 = faintly seen, 2 = well seen, and 3 = excellent visualization). Multivariate analysis was used to investigate the correlation between visualization scores and potential determinants of second-order bile duct opacification, specifically age, body mass index, creatinine level, total and direct bilirubin levels, alkaline phosphatase level, aspartate aminotransferase level, alanine aminotransferase level, patient maximum linear width, CT noise, and hepatosplenic attenuation difference at unenhanced CT.
The mean (± SD) second-order bile duct visualization scores were 2.35 ± 0.66 and 2.55 ± 0.60 for readers 1 and 2, respectively. In the multivariate analysis, the only independent predictors of reduced second-order bile duct visualization were higher alkaline phosphatase level (p = 0.01) and higher CT noise (p = 0.02).
Higher serum alkaline phosphatase level and higher CT noise in potential living liver donors indicate a higher risk of poor second-order bile duct visualization at CT cholangiography.
本文旨在探讨 CT 胆系成像中活体肝移植供者二级胆管显影的决定因素。
我们回顾性分析了 143 例接受 CT 胆系成像检查的潜在活体肝移植供者（83 名男性，60 名女性；平均年龄 37 岁），该检查包括碘普罗胺葡甲胺的缓慢输注，在胆管造影剂给药后 15 分钟进行 CT 采集。两名读者独立地根据之前建立的 4 分制评分标准（0=未显示，1=隐约显示，2=良好显示，3=极好显示）对二级胆管分支的显影进行评分。采用多变量分析来研究可视化评分与二级胆管显影的潜在决定因素之间的相关性，具体因素包括年龄、体重指数、肌酐水平、总胆红素和直接胆红素水平、碱性磷酸酶水平、天冬氨酸转氨酶水平、丙氨酸转氨酶水平、患者最大线性宽度、CT 噪声和未增强 CT 时的肝脾衰减差。
两位读者的平均（±标准差）二级胆管可视化评分分别为 2.35±0.66 和 2.55±0.60。多变量分析显示，碱性磷酸酶水平升高（p=0.01）和 CT 噪声升高（p=0.02）是二级胆管可视化降低的唯一独立预测因素。
潜在活体肝移植供者血清碱性磷酸酶水平升高和 CT 噪声升高提示 CT 胆系成像中二级胆管显示不佳的风险较高。
