Preoperative evaluation of the hepatic vascular anatomy in living liver donors: Comparison of CT angiography and MR angiography

Abstract

Purpose:To compare the diagnostic performance of CT angiography (CTA) and MR angiography (MRA) for preoperative hepatic vascular evaluation in living liver donors. Materials and Methods:Twenty-eight living donor candidates underwent preoperative CTA and MRA. Two blinded radiologists evaluated the anatomic types of the hepatic artery (HA) and portal vein (PV), and the number of aberrant hepatic veins (HVs) on both CTA and MRA, independently. Four grades of confidence levels were used to indicate the clarity of depiction of the HA and PV. Surgical findings were used as a standard of reference. Results:For determining the anatomic types of the HA and PV, and the number of aberrant HVs, CTA and MRA did not significantly differ in terms of accuracy ([89%, 96%, and 68% on CTA] vs. [86%, 93%, and 68% on MRA] for reader 1, P Ͼ 0.05; and [93%, 100%, and 86% on CTA] vs. [89%, 93%, and 79% on MRA] for reader 2, P Ͼ 0.05). Confidence for the depiction of major branches of HA and PV did not differ between CTA and MRA, except for a better depiction of the left HA (LHA) on CTA (P Ͻ 0.05) Conclusion:In living donor candidates, both CTA and MRA can provide a complete evaluation of the hepatic vascular anatomy.

Aberrant Hepatic Artery in Patients Undergoing Pancreaticoduodenectomy

“…Both of them can be used as noninvasive alternatives to catheter angiography before surgery. Accuracy of CTA and MRA for the depiction of hepatic arterial variants has been reported in several articles [10,15,16] , which suggested that three-dimensional CT or MR reconstruction should play an important part in the preoperative evaluation of complex hepato-biliary-pancreatic operations wherever possible.…”

“…Despite the accuracy in our series being 100%, the necessity of performing celiomesenteric angiography preoperatively for PD remains controversial because of its invasive nature. Recently, CT angiography (CTA) and magnetic resonance angiography (MRA) [10][11][12][13][14] have been used commonly to provide valuable preoperative information about abdominal vascular architecture. Both of them can be used as noninvasive alternatives to catheter angiography before surgery.…”

MR Evaluation of Portal Hypertensive Collateral Shunting Vessels for Predicting Outcome after Transjugular Intrahepatic Portosystemic Shunt

“…Preprocedural cross-sectional imaging of the liver and portal system can detect important contraindications to TIPS placement, such as multiple or huge hepatic cysts or hepatocellular carcinomas or obstruction or thrombosis of the portal or hepatic veins. 1,[9][10][11][12][13][14] Many researchers have investigated the relationships between diameter of the portal vein and portal pressure, 16 ‰ow direction, 17 development of the shunting vessels, 18 diameter of the shunting vessels and gastroesophageal bleeding, 19 or onset of encephalopathy. 20 Ito and associates 21 recently reported decreased diameter and hepatopetal ‰ow of the left gastric vein and the presence of non-variceal portosystemic shunt as predictive factors for variceal relapse after endoscopic therapies.…”

“…[9][10][11][12][13][14] We aimed to assess whether MR imaging evaluation of portosystemic collateral shunts can be used to predict therapeutic eŠectiveness of, complications after, and technical di‹culty during TIPS creation.…”

New Imaging Techniques for 90Y Microsphere Radioembolization

“…The detection and subsequent coil embolization of extra hepatic shunting to other gastro-intestinal structures is a major issue during SIRT simulation angiography [43,44]. According to Louie et al [45], the high spatial resolution of CBCT supplements the traditional use of DSA and 99mTc-MAA scintigraphy to predict extrahepatic microsphere deposition.…”