Liao Chien-Chang, Chen Meng-Hsiang, Yu Chun-Yen, Tsang Leung-Chit Leo, Chen Chao-Long, Hsu Hsien-Wen, Lim Wei-Xiong, Chuang Yi-Hsuan, Huang Po-Hsun, Cheng Yu-Fan, Ou Hsin-You
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan.
Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan.
Diagnostics (Basel). 2022 Feb 15;12(2):498. doi: 10.3390/diagnostics12020498.
Since the advent of a new generation of inflow-sensitive inversion recovery (IFIR) technology, three-dimensional non-contrast-enhanced magnetic resonance angiography is being used to obtain hepatic vessel images without applying gadolinium contrast agent. The purpose of this study was to explore the diagnostic efficacy of non-contrast-enhanced magnetic resonance angiography (non-CE MRA), contrast-enhanced magnetic resonance angiography (CMRA), and computed tomography angiography (CTA) in the preoperative evaluation of living liver donors. A total of 43 liver donor candidates who were evaluated for living donor liver transplantation completed examinations. Donors' age, gender, renal function (eGFR), and previous CTA and imaging were recorded before non-CE MRA and CMRA. CTA images were used as the standard. Five different classifications of hepatic artery patterns (types I, III, V, VI, VIII) and three different classifications of portal vein patterns (types I, II, and III) were identified among 43 candidates. The pretransplant vascular anatomy was well identified using combined non-CE MRA and CMRA of hepatic arteries (100%), PVs (98%), and hepatic veins (100%) compared with CTA images. Non-CE MRA images had significantly stronger contrast signal intensity of portal veins ( < 0.01) and hepatic veins ( < 0.01) than CMRA. No differences were found in signal intensity of the hepatic artery between non-CE MRA and CMRA. Combined non-CE MRA and CMRA demonstrate comparable diagnostic ability to CTA and provide enhanced biliary anatomy information that assures optimum donor safety.
自从新一代流入敏感反转恢复（IFIR）技术问世以来，三维非增强磁共振血管造影术正被用于在不使用钆造影剂的情况下获取肝脏血管图像。本研究的目的是探讨非增强磁共振血管造影术（non-CE MRA）、增强磁共振血管造影术（CMRA）和计算机断层血管造影术（CTA）在活体肝供体术前评估中的诊断效能。共有43名接受活体肝移植评估的肝供体候选人完成了检查。在进行non-CE MRA和CMRA之前，记录供体的年龄、性别、肾功能（估算肾小球滤过率）以及之前的CTA和影像学检查结果。以CTA图像作为标准。在43名候选人中识别出了五种不同类型的肝动脉模式（I型、III型、V型、VI型、VIII型）和三种不同类型的门静脉模式（I型、II型和III型）。与CTA图像相比，联合使用肝动脉、门静脉（98%）和肝静脉（100%）的non-CE MRA和CMRA能够很好地识别移植前的血管解剖结构。non-CE MRA图像中门静脉（<0.01）和肝静脉（<0.01）的对比信号强度明显强于CMRA。non-CE MRA和CMRA之间肝动脉的信号强度没有差异。联合使用non-CE MRA和CMRA显示出与CTA相当的诊断能力，并提供了增强的胆道解剖信息，确保供体的最佳安全性。
