MRI for evaluation of potential living liver donors: a new approach including contrast-enhanced magnetic resonance cholangiography

Mangold, Stefanie; Bretschneider, Christiane; Fenchel, Michael; Seeger, Achim; Krämer, Ulrich; Klumpp, Bernhard; Nadalin, Silvio; Königsrainer, Alfred; Claussen, Claus D.; Miller, Stephan

doi:10.1007/s00261-011-9736-7

Cited by 31 publications

(13 citation statements)

References 32 publications

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“…Visualization scores for second order bile ducts were significantly higher on 2D R2* imaging than the 3D T1w MRC. Recent studies have shown that Gd-EOB-DTPA-enhanced 3D T1w MRC is superior to T2w MRC for visualization of second-order bile ducts [3, 4]. In the current proof-of-concept study, we implemented a T1w ME SPGR technique to exploit both T1 shortening and T2* effect and we showed proof-of-concept that R2* maps may provide better visualization of ducts than T1w MRC.…”

Section: Discussionmentioning

confidence: 84%

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Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors

Dehkordy

Fowler²,

Wolfson

et al. 2017

Abdom Radiol

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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-EOBDT-PA 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 Tlw 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* mapping 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.

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Section: Discussionmentioning

confidence: 84%

“…Recent studies have suggested that the addition of gadoxetate-disodium (Gd-EOB-DTPA)-enhanced three-dimensional (3D) T1-weighted (T1w) MRC to T2w MRC improves depiction of biliary anatomy in living donors [3, 4]. Gd-EOB-DTPA is taken up by hepatocytes and excreted into bile with resultant T1 shortening of the bile (i.e., the bile ducts appear hyperintense).…”

mentioning

confidence: 99%

Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors

Dehkordy

Fowler²,

Wolfson

et al. 2017

Abdom Radiol

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“…In the past years, numerous other techniques, including contrast-enhanced sequences have been evaluated, nevertheless, until now, 3D T2 weighted sequences have proven to provide the visualisation of the bile ducts of the highest image quality [10, 11, 14]. This is in line with the findings of our study, as the depiction of the extrahepatic and intrahepatic bile ducts by navigator-triggered T1 3D MRC can be performed with a high image quality, however not superior to T2 MRCP.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of gadoxetate disodium enhanced 3D T1 MR cholangiography (MRC) with a specific inversion recovery prepulse for the assessment of the hepatobiliary system

et al. 2018

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AimTo compare the potential of a gadoxetate disodium enhanced navigator-triggered 3D T1 magnetic-resonance cholangiography (MRC) sequence with a specific inversion recovery prepulse to T2-weighted MRCP for assessment of the hepatobiliary system.Materials and methods30 patients (12 male, 18 female) prospectively underwent conventional navigator-triggered 3D turbo spin-echo T2-weighted MRCP and 3D T1 MRC with a specific inversion pulse to minimise signal from the liver 30 minutes after administration of gadoxetate disodium on a 1.5 T MRI system. For qualitative evaluation, biliary duct depiction was assessed segmentally following a 5-point Likert scale. Visualisation of hilar structures as well as image quality was recorded. Additionally, the extrahepatic bile ducts were assessed quantitatively by calculation of signal-to-noise ratios (SNR).ResultsThe advantages of T1 3D MRC include reduced affection of image quality by bowel movement and robust depiction of the relative position of the extrahepatic bile ducts in relation to the portal vein and the duodenum compared to T2 MRCP. However, overall T1 3D MRC did not significantly (p > 0.05) improve the biliary duct depiction compared to T2 MRCP in all segments: Common bile duct 4.1 vs. 4.4, right hepatic duct 3.6 vs. 4.2, left hepatic duct 3.5 vs. 4.1. Image quality did not differ significantly (p > 0.05) between both sequences (3.6 vs. 3.5). SNR measurements for the hepatobiliary system did not differ significantly (p > 0.05) between navigator-triggered T1 3D MRC and T2 MRCP.ConclusionsThis preliminary study demonstrates that T1 3D MRC of a specific inversion recovery prepulse has potential to complement T2 MRCP, especially for the evaluation of liver structures close to the hilum in the diagnostic work-up of the biliary system in patients receiving gadoxetate disodium.

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“…The use of larger flip angles (e.g., 35°) is recommended in order to increase the conspicuity of the biliary tree over the background [32] . Despite the increasing use of CE-MRC, there is a paucity of literature-based evidence in the setting of OLT, mainly focused on the preoperative evaluation of liver donors [33,34] . However, studies on patients with BC after hepatobiliary surgery, including OLT subjects, suggest that CE-MRC improves the accuracy of C-MRC in evaluating bile leakage showing the site of the leak and direct contrast extravasation into perihepatic/peribiliary fluid collections [35] .…”

Section: Contrast-enhanced Mrcmentioning

confidence: 99%

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

Girometti

Cereser

Bazzocchi

et al. 2014

WJR

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Core tip:The review is focused on three main topics, in order to emphasize why magnetic resonance cholangiography (MRC) is the preferred imaging modality to noninvasively assess the biliary system after orthotopic liver transplantation. First, the authors describe the different techniques that can be used, namely conventional MRC and contrast-enhanced MRC. Second, exemplificative imaging findings are illustrated in order to show the diagnostic reliability of the technique. Third, the Authors discuss the state-of-the-art role for MRC in assessing biliary complications as emerging from updated literature review. INTRODUCTIONDespite improvements in organ preservation, surgical technique, immunosuppression and postoperative management, biliary complications (BC) still represent the "Achille's heel" of orthotopic liver transplantation (OLT),

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MRI for evaluation of potential living liver donors: a new approach including contrast-enhanced magnetic resonance cholangiography

Abstract: This protocol allows the evaluation of liver donors especially with regard to the biliary structures. However, the depiction of the arterial anatomy requires further technical developments.

Cited by 31 publications

References 32 publications

Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors

Technical report: gadoxetate-disodium-enhanced 2D R2* mapping: a novel approach for assessing bile ducts in living donors

Feasibility of gadoxetate disodium enhanced 3D T1 MR cholangiography (MRC) with a specific inversion recovery prepulse for the assessment of the hepatobiliary system

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT

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