Skip to main content
SpringerLink
Log in

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

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Objectives

To assess the feasibility of a comprehensive MRI protocol using intrabiliary contrast medium (gadolinium-EOB-DTPA) for evaluation of living liver donors.

Material and methods

In this prospective study, 30 donor candidates for living-related liver transplantation (17 men; 13 women, mean age 37 ± 10.9 years) underwent MRI including MR-angiography (MRA) as well as a conventional T2-weighted MR-cholangiography (MRC) and a contrast-enhanced sequence for depiction of the biliary structures. MRC and MRA images were evaluated for quality on a four-point-scale (score of 0 indicated poor and a score of 3, excellent image quality). Anatomic variants of the arterial, venous, portal venous, and biliary structures were identified.

Results

Image quality was diagnostic in all examinations except for 4 of 30 MRA data sets. Intrahepatic biliary structures, especially with regard to the intrahepatic bile ducts of 2nd and 3rd order could be identified with significantly increased image quality than in conventional T2-weighted MRC sequences (P = 0.005 and P = 0.035). A high percentage rate of anatomic variants regarding the biliary, arterial, venous, and portal venous anatomy was found.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Strong RW, Lynch SV, Ong TH, et al. (1990) Successful liver transplantation from a living donor to her son. N Engl J Med 322(21):1505–1507

    Article  PubMed  CAS  Google Scholar 

  2. Schroeder T, Malagó M, Debatin JF, et al. (2005) “All-in-one” imaging protocols for the evaluation of potential living liver donors: comparison of magnetic resonance imaging and multidetector computed tomography. Liver Transpl 11(7):776–787

    Article  PubMed  Google Scholar 

  3. Raia S, Nery JR, Mies S (1989) Liver transplantation from live donors. Lancet 26(2):497–498

    Article  Google Scholar 

  4. Rogiers X, Burdelski M, Broelsch CE (1994) Liver transplantation from living donors. Br J Surg 81:1251–1253

    Article  PubMed  CAS  Google Scholar 

  5. Broelsch CE, Emond JC, Whitington PF, et al. (1989) Application of reduced-size liver transplants as split grafts, auxiliary grafts, and living related segmental transplants. Ann Surg 212:368–375

    Article  Google Scholar 

  6. Hashikura Y, Makuuchi M, Kawasaki S, et al. (1994) Successful living-related partial liver transplantation to an adult patient. Lancet 343:1233–1234

    Article  PubMed  CAS  Google Scholar 

  7. Broelsch CE, Testa G, Alexandrou A, Malago M (2002) Living related liver transplantation: medical and social aspects of a controversial therapy. Gut 50:143–145

    Article  PubMed  CAS  Google Scholar 

  8. Mueller AR, Pascher A, Platz KP, et al. (2003) Immunosuppressive management following intestinal transplantation in adult patients. Transplant Proc 35:2075–2077

    Article  PubMed  CAS  Google Scholar 

  9. Settmacher U, Neuhaus P (2003) Innovations in liver surgery through transplantation from living donors. Chirurgie 74:536–546

    Article  CAS  Google Scholar 

  10. Kim SY, Kim KW, Kim MJ, et al. (2007) Multidetector row CT of various hepatic artery complications after living donor liver transplantation. Abdom Imaging 32(5):635–643

    Article  PubMed  Google Scholar 

  11. Girometti R, Cereser L, Como G, Zuiani C, Bazzocchi M (2008) Biliary complications after orthotopic liver transplantation: MRCP findings. Abdom Imaging 33(5):542–554

    Article  PubMed  Google Scholar 

  12. Fan S, Lo C, Liu C, et al. (2000) Safety of donors in live donor liver transplantation using right lobe grafts. Arch Surg 135:336–340

    Article  PubMed  CAS  Google Scholar 

  13. Marcos A, Fisher RA, Ham JM, et al. (1999) Right lobe living donor liver transplantation. Transplantation 68:798–800

    Article  PubMed  CAS  Google Scholar 

  14. Tanaka K, Kiuchi T (2002) Living-donor liver transplantation in the new decade: perspective from the twentieth to the twenty-first century. J Hepatobiliary Pancreat Surg 9:218–222

    Article  PubMed  Google Scholar 

  15. Testa G, Malago M, Valentin-Gamazo C, Lindell G, Broelsch CE (2000) Biliary anastomosis in living related liver transplantation using the right liver lobe: techniques and complications. Liver Transpl 6:710–714

    Article  PubMed  CAS  Google Scholar 

  16. Tsang LL-C, Chen C-L, Huang T-L, et al. (2008) Preoperative imaging evaluation of potential living liver donors: reasons for exclusion from donation in adult living donor liver transplantation. Transplant Proc 40:2460–2462

    Article  PubMed  Google Scholar 

  17. Becker CD, Grossholz M, Becker M, et al. (1997) Choledocholithiasis and bile duct stenosis: diagnostic accuracy of MR cholangiopancreatography. Radiology 205:523–530

    PubMed  CAS  Google Scholar 

  18. Lim JS, Kim MJ, Myoung S, et al. (2008) MR cholangiography for evaluation of hilar branching anatomy in transplantation of the right hepatic lobe from a living donor. AJR 191:537–545

    Article  PubMed  Google Scholar 

  19. Hintze RE, Adler A, Veltzke W, et al. (1997) Clinical significance of magnetic resonance cholangiopancreatography (MRCP) compared to endoscopic retrograde cholangiopancreatography (ERCP). Endoscopy 29:182–187

    Article  PubMed  CAS  Google Scholar 

  20. Holzapfel K, Breitwieser C, Prinz C, Rummeny EJ, Gaa J (2007) Contrast-enhanced magnetic resonance cholangiography using gadolinium-EOB-DTPA. Preliminary experience and clinical applications. Radiologe 47:536–544

    Article  PubMed  CAS  Google Scholar 

  21. Carlos RC, Hussain HK, Song JH, Francis IR (2002) Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid as an intrabiliary contrast agent: preliminary assessment. AJR 179:87–92

    PubMed  Google Scholar 

  22. Michel NA (1955) Blood supply and anatomy of the upper abdominal organs with a descriptive atlas. Philadelphia, PA: Lippincott, pp 64–69

    Google Scholar 

  23. Yoshida J, Chijiiwa K, Yamaguchi K, Yokohata K, Tanaka M (1996) Practical classification of the branching types of the biliary tree: an analysis of 1, 094 consecutive direct cholangiograms. J Am Coll Surg 182:37–40

    PubMed  CAS  Google Scholar 

  24. Sahani D, Mehta A, Blake M, et al. (2004) Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. RadioGraphics 24:1367–1380

    Article  PubMed  Google Scholar 

  25. Winter TC III, Nghiem HV, Freeny PC, Hommeyer SC, Mack LA (1995) Hepatic arterial anatomy: demonstration of normal supply and vascular variants with three-dimensional CT angiography. RadioGraphics 15:771–780

    PubMed  Google Scholar 

  26. Soyer P, Heath D, Bluemke DA, et al. (1996) Three-dimensional helical CT of intrahepatic venous structures: comparison of three rendering techniques. J Comput Assist Tomogr 20:122–127

    Article  PubMed  CAS  Google Scholar 

  27. Sugarbaker PH, Nelson RC, Murray DR, Chezmar JL, Bernardino ME (1990) A segmental approach to computerized tomographic portography for hepatic resection. Surg Gynecol Obstet 171:189–195

    PubMed  CAS  Google Scholar 

  28. Nilsson U (1987) Adverse reactions to iotroxate at intravenous cholangiography. A prospective clinical investigation and review of the literature. Acta Radiol 28:571–575

    Article  PubMed  CAS  Google Scholar 

  29. Schroeder T, Nadalin S, Stattaus J, et al. (2002) Potential living liver donors: evaluation with an all-in-one protocol with multi-detector row CT. Radiology 224(2):586–591

    Article  PubMed  Google Scholar 

  30. Cheng YF, Chen CL, Huang TL, et al. (2001) Single imaging modality evaluation of living donors in liver transplantation: magnetic resonance imaging. Transplantation 72(9):1527–1533

    Article  PubMed  CAS  Google Scholar 

  31. Goyen M, Barkhausen J, Debatin JF, et al. (2002) Right-lobe living related liver transplantation: evaluation of a comprehensive magnetic resonance imaging protocol for assessing potential donors. Transplantation 8(3):241–250

    Google Scholar 

  32. Lee VS, Morgan GR, Teperman LW, et al. (2001) MR imaging as the sole preoperative imaging modality for right hepatectomy: a prospective study of living adult-to-adult liver donor candidates. AJR 176:1475–1482

    PubMed  CAS  Google Scholar 

  33. An SK, Lee JM, Suh KS, et al. (2006) Gadobenate dimeglumine-enhanced liver MRI as the sole preoperative imaging technique: a prospective study of living liver donors. AJR 187:1223–1233

    Article  PubMed  Google Scholar 

  34. Goldman J, Florman S, Varotti G, et al. (2003) Noninvasive preoperative evaluation of biliary anatomy in right-lobe living donors with mangafodipir trisodium-enhanced MR cholangiography. Transplant Proc 35:1421–1422

    Article  PubMed  CAS  Google Scholar 

  35. Lee VS, Krinsky GA, Nazzaro CA, et al. (2004) Defining intrahepatic biliary anatomy in living liver transplant donor candidates at mangafodipir trisodium-enhanced MR cholangiography versus conventional T2-weighted MR Cholangiography. Radiology 233(3):659–666

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany

    S. Mangold, C. Bretschneider, M. Fenchel, A. Seeger, U. Kramer, B. Klumpp, C. D. Claussen & S. Miller

  2. Department of General, Visceral, and Transplant Surgery, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany

    S. Nadalin & A. Königsrainer

Authors
  1. S. Mangold
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Bretschneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Fenchel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Seeger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. U. Kramer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Klumpp
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Nadalin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Königsrainer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. D. Claussen
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S. Miller
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Mangold.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mangold, S., Bretschneider, C., Fenchel, M. et al. MRI for evaluation of potential living liver donors: a new approach including contrast-enhanced magnetic resonance cholangiography. Abdom Imaging 37, 244–251 (2012). https://doi.org/10.1007/s00261-011-9736-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-011-9736-7

Keywords

Search

Navigation