The utility of MRCP in preoperative mapping of biliary anatomy in adult-to-adult living related liver transplant donors.

To assess the utility of magnetic resonance cholangiopancreatography (MRCP) in preoperative mapping of biliary anatomy in adult-to-adult living related liver transplant (LRLT) donors. From 57 potential donors with preoperative MRCP, 27 cases (16 men, 11 women, age range 22-51 years, mean 37.2 years) underwent right lobe resection and had intraoperative cholangiography (IOC) for comparison. The MRCP and IOC reports were retrospectively reviewed in all 27 cases. The MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2-weighted sequences in axial/coronal thin sections, and variable-thickness rotating slabs. The accuracy of preoperative MRCP for biliary mapping in potential LRLT donors was analyzed compared to the IOC findings. Of 27 donors, 26 (96.3%) had MRCP which showed adequate information of central intrahepatic biliary anatomy. Of these, 19 had normal bifurcation confirmed by IOC, and single biliary anastomosis was created in the recipient at transplantation. MRCP correctly predicted 17 of 19 normal cases (sensitivity for normals: 89.5%). In seven donors with variant biliary anatomy, two separate biliary anastomoses were performed in the recipient. MRCP correctly predicted five of seven variants (sensitivity for variants: 71.4%). Overall, MRCP had an accuracy 84.6% (22/26). MRCP has potential in the preoperative assessment of nondilated bile ducts in LRLT donors, however further improvements are desired to increase its quality and accuracy.

Limanond P ，Raman SS ，Ghobrial RM ，Busuttil RW ，Lu DS ... -  《JOURNAL OF MAGNETIC RESONANCE IMAGING》

The value of magnetic resonance cholangiography in the preoperative assessment of living liver donors.

Sirvanci M ，Duran C ，Ozturk E ，Balci D ，Dayangaç M ，Onat L ，Yüzer Y ，Tokat Y ，Killi R ... -  《CLINICAL IMAGING》

Stratifying risk of biliary complications in adult living donor liver transplantation by magnetic resonance cholangiography.

Kashyap R ，Bozorgzadeh A ，Abt P ，Tsoulfas G ，Maloo M ，Sharma R ，Patel S ，Dombroski D ，Mantry P ，Safadjou S ，Jain A ，Orloff M ... -  《TRANSPLANTATION》

Morphine- and glucagon-augmented magnetic resonance cholangiopancreatography to evaluate living liver donors.

The purpose of this study was to investigate the effectiveness of the combined use of intravenous morphine and intramuscular glucagon in improving magnetic resonance cholangiopancreatography (MRCP) image quality in donors for living-related liver transplantation. Sixteen healthy donor candidates underwent an MRCP study. Coronal, single-shot, fast spin-echo, heavily T2-weighted dynamic MRCP images were obtained before and 3 minutes after the intravenous administration of morphine HCl with a dose of 0.04 mg/kg. Thirty minutes after the injection of morphine, intramuscular glucagon was used. Another MRCP image of the same pulse sequence was generated 15 minutes after the injection of glucagon with a dose of 1 mg. The diameter, signal intensity, and number of branches of bile ducts in MRCP images taken immediately before and after the injection of morphine and after the injection of glucagon (plus delayed morphine effects) were compared and analyzed. In all 16 donor candidates, the diameters of the right and left hepatic ducts, common bile duct, and main pancreatic duct were significantly increased (P < 0.05) in the MRCP images taken 3 minutes after the injection of morphine and 15 minutes after the injection of glucagon (plus delayed morphine effects) in comparison with MRCP images taken before any drug administration. The qualitative grading scores of the signal intensity and order of branches of bile ducts revealed improvements in the MRCP images after the injection of glucagon (plus delayed morphine effects; P < 0.05). In conclusion, combining the intravenous administration of low-dose morphine and the intramuscular use of glucagon before MRCP examination improves the visualization of the nondilated biliary ductal anatomy, which is important for the preoperative biliary evaluation of donor candidates for living-related liver transplantation.

Mo YH ，Liang PC ，Ho MC ，Lee PH ，Jaw FS ，Peng SS ... -  《-》

Preoperative evaluation of biliary anatomy in adult live liver donors with volumetric mangafodipir trisodium enhanced magnetic resonance cholangiography.

Ayuso JR ，Ayuso C ，Bombuy E ，De Juan C ，Llovet JM ，De Caralt TM ，Sánchez M ，Pagés M ，Bruix J ，García-Valdecasas JC ... -  《LIVER TRANSPLANTATION》