Mazroua Jehan A, Almalki Yassir Edrees, Alaa Mohamed, Alduraibi Sharifa Khalid, Aboualkheir Mervat, Aldhilan Asim S, Almushayti Ziyad A, Aly Sameh Abdelaziz, Basha Mohammad Abd Alkhalik
Department of Diagnostic Radiology, Faculty of Human Medicine, Mansoura University, Mansoura 35516, Egypt.
Division of Radiology, Department of Internal Medicine, Medical College, Najran University, Najran 61441, Saudi Arabia.
Diagnostics (Basel). 2023 Feb 14;13(4):726. doi: 10.3390/diagnostics13040726.
Despite significant advances in hepatobiliary surgery, biliary injury and leakage remain typical postoperative complications. Thus, a precise depiction of the intrahepatic biliary anatomy and anatomical variant is crucial in preoperative evaluation. This study aimed to evaluate the precision of 2D and 3D magnetic resonance cholangiopancreatography (MRCP) in exact mapping of intrahepatic biliary anatomy and its variants anatomically in subjects with normal liver using intraoperative cholangiography (IOC) as a reference standard. Thirty-five subjects with normal liver activity were imaged via IOC and 3D MRCP. The findings were compared and statistically analyzed. Type I was observed in 23 subjects using IOC and 22 using MRCP. Type II was evident in 4 subjects via IOC and 6 via MRCP. Type III was observed equally by both modalities (4 subjects). Both modalities observed type IV in 3 subjects. The unclassified type was observed in a single subject via IOC and was missed in 3D MRCP. Accurate detection by MRCP of intrahepatic biliary anatomy and its anatomical variants was made in 33 subjects out of 35, with an accuracy of 94.3% and a sensitivity of 100%. In the remaining two subjects, MRCP results provided a false-positive pattern of trifurcation. MRCP competently maps the standard biliary anatomy.
尽管肝胆外科取得了显著进展，但胆瘘和胆漏仍是典型的术后并发症。因此，精确描绘肝内胆管解剖结构及其变异对于术前评估至关重要。本研究旨在以术中胆管造影（IOC）作为参考标准，评估二维和三维磁共振胰胆管造影（MRCP）在正常肝脏受试者中对肝内胆管解剖结构及其变异进行精确解剖定位的准确性。对35例肝功能正常的受试者进行了IOC和三维MRCP成像。对结果进行比较并进行统计学分析。IOC检查发现23例为I型，MRCP检查发现22例为I型。IOC检查发现4例为II型，MRCP检查发现6例为II型。两种检查方式观察到III型的均为4例。两种检查方式观察到IV型的均为3例。IOC检查发现1例为未分类型，三维MRCP检查漏诊。35例受试者中，33例通过MRCP准确检测出肝内胆管解剖结构及其变异，准确率为94.3%，灵敏度为100%。在其余2例受试者中，MRCP结果呈现出假阳性的三叉分支模式。MRCP能够很好地显示标准胆管解剖结构。
