Joint Department of Medical Imaging, Mount Sinai Hospital & Women's College Hospital, University Health Network, University of Toronto, 610 University Ave, 3-957, Toronto, ON M5G, Canada.
Department of Surgery, University Health Network, University of Toronto, 610 University Ave, 3-957, Toronto, ON M5G, Canada.
Abdom Radiol (NY). 2018 Jul;43(7):1682-1692. doi: 10.1007/s00261-017-1379-x.
To retrospectively evaluate gadoxetic acid-enhanced magnetic resonance angiography (MRA) using controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) technique for mapping hepatic vascular anatomy in potential living liver donors, with CT angiography (CTA) as reference standard.
82 potential living liver donors who underwent MRA and CTA were enrolled in this HIPAA-compliant IRB-approved study. MRA and CTA images were evaluated by two reviewers in consensus with respect to (1) image quality scores for depiction of the hepatic vessels and (2) accuracy of MRA for determining the hepatic vascular variants with CTA as reference standard. The image quality scores were compared using Fisher's exact test between MRA and CTA.
The accuracy for determining the hepatic arterial, portal, and hepatic venous variants and segment IV arterial origin was 73, 90, 79, and 55%, respectively, compared to CTA. However, subjective image quality for depiction of hepatic arteries in MRA was significantly lower than CTA (p < 0.001). The portal and hepatic venous image quality was almost equal in both modalities (p = 0.059) except left hepatic vein being depicted better on CT images (p = 0.023).
Gadoxetic acid-enhanced MRA using CAIPIRINHA technique is feasible for mapping hepatic vasculature in potential living liver donors, with moderate accuracy for arterial variants and good to excellent results for hepatic and portal vein variants, compared with CTA. However, the specific delineation of segment IV arterial origin was possible in just over half of the liver donors with MRA.
回顾性评估钆塞酸增强磁共振血管造影（MRA）使用平行成像的控制混叠技术（CAIPIRINHA）在潜在活体肝供者肝血管解剖中的应用，以 CT 血管造影（CTA）作为参考标准。
本 HIPAA 合规性 IRB 批准的研究共纳入 82 例接受 MRA 和 CTA 的潜在活体肝供者。MRA 和 CTA 图像由两位观察者进行评估，内容包括（1）肝血管显示的图像质量评分，（2）以 CTA 为参考标准，MRA 确定肝血管变异的准确性。使用 Fisher 精确检验比较 MRA 和 CTA 的图像质量评分。
与 CTA 相比，MRA 确定肝动脉、门静脉和肝静脉变异以及 IV 段动脉起源的准确性分别为 73%、90%、79%和 55%。然而，MRA 显示肝动脉的主观图像质量明显低于 CTA（p<0.001）。两种模态的门静脉和肝静脉图像质量几乎相等（p=0.059），除左肝静脉在 CT 图像上显示更好（p=0.023）外。
与 CTA 相比，使用 CAIPIRINHA 技术的钆塞酸增强 MRA 可用于潜在活体肝供者肝血管成像，对于动脉变异具有中等准确性，对于肝和门静脉变异具有良好至优秀的结果。然而，MRA 仅能确定超过一半的肝供者的 IV 段动脉起源。
