From the Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Pusan National University, Yangsan Hospital, Yangsan, Korea.
Exp Clin Transplant. 2021 Mar;19(3):244-249. doi: 10.6002/ect.2020.0329.
The steatosis of graft liver is an important factor in liver transplant that determines the graft function in the recipient and the recovery of the remnant liver in the living donor. We analyzed the data of living donors from our center to evaluate whether magnetic resonance imaging and magnetic resonance spectroscopy can replace liver biopsy.
From May 2010 to May 2019, data from a total of 239 living donors was collected. There were 84 patients who had no magnetic resonance imaging or magnetic resonance spectroscopy data, and they were excluded. The result of preoperative liver biopsy was compared with preoperative magnetic resonance imaging and magnetic resonance spectroscopy data. The steatosis was defined by the degree of macrosteatosis.
The magnetic resonance imaging of the fat fraction was a good parameter to predict fatty changes between normal and fatty liver groups (3.09 ± 3.38% for normal 7.48 ± 4.07% for fatty liver; P < .001). The magnetic resonance spectroscopy was also a good parameter to predict fatty changes between normal and fatty liver groups (2.09 ± 1.43% for normal and 6.89 ± 2.68% for fatty liver; P < .001). Linear regression showed that pathology results were significantly correlated with magnetic resonance spectroscopy (P < .001, R2 = 0.604) but not with magnetic resonance imaging (P < .001, R2 = 0.227).
Magnetic resonance spectroscopy has several benefits for quantifying hepatic steatosis during a living donor liver transplant evaluation, including no radiation exposure, and a noninvasive procedure. Moreover, preoperative magnetic resonance spectroscopy can determine an anatomic variation of the bile duct, which helps improve the safety of the living donor. However, more clinical data and further studies are needed to ensure that preoperative magnetic resonance spectroscopy is essential.
供体肝脏脂肪变性是肝移植中的一个重要因素，它决定了受体中移植物的功能和活体供体剩余肝脏的恢复。我们分析了来自我们中心的活体供体数据，以评估磁共振成像和磁共振波谱是否可以替代肝活检。
从 2010 年 5 月至 2019 年 5 月，共收集了 239 名活体供体的数据。有 84 名患者没有磁共振成像或磁共振波谱数据，将其排除在外。将术前肝活检结果与术前磁共振成像和磁共振波谱数据进行比较。脂肪变性程度定义为宏观脂肪变性程度。
磁共振成像的脂肪分数是预测正常和脂肪肝组脂肪变化的良好参数（正常组为 3.09 ± 3.38%，脂肪肝组为 7.48 ± 4.07%；P <.001）。磁共振波谱也是预测正常和脂肪肝组脂肪变化的良好参数（正常组为 2.09 ± 1.43%，脂肪肝组为 6.89 ± 2.68%；P <.001）。线性回归显示，病理结果与磁共振波谱显著相关（P <.001，R2 = 0.604），但与磁共振成像不相关（P <.001，R2 = 0.227）。
磁共振波谱在活体供肝移植评估中定量评估肝脂肪变性具有以下优点：无辐射、非侵入性。此外，术前磁共振波谱可以确定胆管的解剖变异，有助于提高活体供者的安全性。但是，需要更多的临床数据和进一步的研究来确保术前磁共振波谱的必要性。
