Abstract
Purpose
Gadoxetate-disodium (Gd-EOB-DTPA)-enhanced 3D T1- weighted (T1w) MR cholangiography (MRC) is an efficient method to evaluate biliary anatomy due to T1 shortening of excreted contrast in the bile. A method that exploits both T1 shortening and T2* effects may produce even greater bile duct conspicuity. The aim of our study is to determine feasibility and compare the diagnostic performance of two-dimensional (2D) T1w multi-echo (ME) spoiled gradient-recalled-echo (SPGR) derived R2* maps against T1w MRC for bile duct visualization in living liver donor candidates.
Materials and methods
Ten potential living liver donor candidates underwent pretransplant 3T MRI and were included in our study. Following injection of Gd-EOBDTPA and a 20-min delay, 3D T1w MRC and 2D T1w ME SPGR images were acquired. 2D R2* maps were generated inline by the scanner assuming exponential decay. The 3D T1w MRC and 2D R2* maps were retrospectively and independently reviewed in two separate sessions by three radiologists. Visualization of eight bile duct segments was scored using a 4-point ordinal scale. The scores were compared using mixed effects regression model.
Results
Imaging was tolerated by all donors and R2* maps were successfully generated in all cases. Visualization scores of 2D R2* maps were significantly higher than 3D T1w MRC for right anterior (p = 0.003) and posterior (p = 0.0001), segment 2 (p < 0.0001), segment 3 (p = 0.0001), and segment 4 (p < 0.0001) ducts.
Conclusions
Gd-EOB-DTPA-enhanced 2D R2* map** is a feasible method for evaluating the bile ducts in living donors and may be a valuable addition to the living liver donor MR protocol for delineating intrahepatic biliary anatomy.
Similar content being viewed by others
References
Catalano OA, Singh AH, Uppot RN, et al. (2008) Vascular and biliary variants in the liver: implications for liver surgery. RadioGraphics 28:359–378. doi:10.1148/rg.282075099
Lim JS, Kim M-J, Myoung S, et al. (2008) MR cholangiography for evaluation of hilar branching anatomy in transplantation of the right hepatic lobe from a living donor. Am J Roentgenol 191:537–545. doi:10.2214/AJR.07.3162
Cai L, Yeh BM, Westphalen AC, et al. (2016) 3D T2-weighted and Gd-EOB-DTPA-enhanced 3D T1-weighted MR cholangiography for evaluation of biliary anatomy in living liver donors. Abdom Radiol . doi:10.1007/s00261-016-0936-z
Mangold S, Bretschneider C, Fenchel M, et al. (2012) MRI for evaluation of potential living liver donors: a new approach including contrast-enhanced magnetic resonance cholangiography. Abdom Imaging 37:244–251. doi:10.1007/s00261-011-9736-7
Yokoo T, Shiehmorteza M, Hamilton G, et al. (2011) Estimation of hepatic proton-density fat fraction by using MR imaging at 3.0 T. Radiology 258:749–759. doi:10.1148/radiol.10100659
Brown RS, Russo MW, Lai M, et al. (2003) A survey of liver transplantation from living adult donors in the United States. N Engl J Med 348:818–825. doi:10.1097/01.sa.0000119084.92230.f7
Lo C-M (2003) Complications and long-term outcome of living liver donors: a survey of 1,508 cases in five Asian centers. Transplantation 75:S12–S15. doi:10.1097/01.TP.0000046534.45645.47
Kim SY, Byun JH, Lee SS, et al. (2010) Biliary tract depiction in living potential liver donors: intraindividual comparison of MR cholangiography at 3.0 and 1.5 T. Radiology 254:469–478. doi:10.1148/radiol.09090003
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
National Institutes of Health Grant T32 EB005970-09.
Conflicts of interest
SFD was supported by a T32 Grant from the NIH (4T32EB005970-09) at the time of the study. KF declares that she has no conflict of interest. TW declares that she has no conflict of interest. SI declares that she has no conflict of interest. CLP declares that she has no conflict of interest. JH declares that he has no conflict of interest. CH declares that he has no conflict of interest. AM declares that she has no conflict of interest. AG declares that he has no conflict of interest. AH declares that he has no conflict of interest. CS has received research grants from Siemens, GE, and Guerbet. CS also consults and advises for Alexion, AstraZeneca, Bioclinica, BMS, Fibrogen, Galmed, Genzyme, Gilead, Fibrogen, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, Virtual Scopics.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Due to retrospective and observational nature of our study, patient consent was not required by the IRB.
Rights and permissions
About this article
Cite this article
Fazeli Dehkordy, S., Fowler, K.J., Wolfson, T. et al. Technical report: gadoxetate-disodium-enhanced 2D R2* map**: a novel approach for assessing bile ducts in living donors. Abdom Radiol 43, 1656–1660 (2018). https://doi.org/10.1007/s00261-017-1365-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-017-1365-3