Chen W-T, Liang J-L, Chen M-H, Liao C-C, Huang T-L, Chen T-Y, Tsang L L-C, Ou H-Y, Hsu H-W, Lazo M Z, Chen C-L, Cheng Y-F
Liver Transplantation Program, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Liver Transplantation Program, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Transplant Proc. 2016 May;48(4):1032-5. doi: 10.1016/j.transproceed.2015.12.083.
Vascular anatomy is essential in pretransplantation survey. The purpose of this study is to investigate the feasibility and diagnostic performance of inflow sensitive inversion recovery (IFIR) magnetic resonance angiography (MRA) to evaluate the recipient's hepatic vasculature before liver transplantation.
Thirty-one pre-liver transplantation patients underwent both IFIR and conventional contrast-enhanced MRA using a 1.5T MR scanner from December 2012 to December 2014. The contrast-to-noise ratios (CNRs) between liver parenchyma and hepatic vasculature were calculated. The image sets of IFIR and contrast-enhanced MRA were assessed for subjective image quality and depiction of hepatic vasculature on vessel-to-vessel basis by two independent radiologists.
The quantitative results of CNR for hepatic arteries on IFIR were significantly lower than contrast-enhanced MRA, whereas CNR for portal veins and inferior vena cava on IFIR were significantly higher than contrast-enhanced MRA. For subjective assessment of image quality, the overall agreement of scores of IFIR and contrast-enhanced MRA was substantial (kappa values ranged from 0.650 to 0.767). There was no significant difference in the image quality for portal veins between IFIR and contrast-enhanced MRA. The quality scores of IFIR were significantly lower than contrast-enhanced MRA for hepatic arteries. For inferior vena cava evaluation, the scores of IFIR were significantly higher than contrast-enhanced MRA.
IFIR MRA is a reproducible and noninvasive tool to assess the hepatic vasculature that can provide adequate to good image quality. In pre-liver transplantation patients, IFIR MRA becomes even more useful if contrast medium is a contraindication due to impaired renal and liver functions.
血管解剖在肝移植术前评估中至关重要。本研究旨在探讨流入敏感反转恢复(IFIR)磁共振血管造影(MRA)评估肝移植受者肝血管系统的可行性及诊断效能。
2012年12月至2014年12月期间,31例肝移植术前患者使用1.5T磁共振扫描仪接受了IFIR及传统对比增强MRA检查。计算肝实质与肝血管系统之间的对比噪声比(CNR)。由两名独立的放射科医生对IFIR和对比增强MRA的图像集进行主观图像质量评估,并逐一对肝血管进行描绘。
IFIR上肝动脉的CNR定量结果显著低于对比增强MRA,而IFIR上门静脉和下腔静脉的CNR显著高于对比增强MRA。对于图像质量的主观评估,IFIR和对比增强MRA评分的总体一致性较高(kappa值范围为0.650至0.767)。IFIR和对比增强MRA在门静脉图像质量上无显著差异。IFIR对肝动脉的质量评分显著低于对比增强MRA。对于下腔静脉评估,IFIR的评分显著高于对比增强MRA。
IFIR MRA是一种可重复且无创的评估肝血管系统的工具,能够提供足够好的图像质量。在肝移植术前患者中,如果因肾功能和肝功能受损而禁忌使用造影剂,IFIR MRA会更有用。