"All-in-one" imaging protocols for the evaluation of potential living liver donors: comparison of magnetic resonance imaging and multidetector computed tomography

Abstract

In order to compare the performance of "all-in-one" magnetic resonance imaging (MRI) and "all-in-one" multidetector computed tomography (MDCT) in the preharvest evaluation 25 potential living donors underwent both MRI and MDCT. MRI was performed on a high-performance 1.5-T scanner, computed tomography (CT) on a 4-row multidetector-scanner. Both scan protocols included angiography of the arterial and venous hepatic systems. CT additionally included infusion of a biliary contrast agent. Data analysis was performed by 4 reviewers, based on source images, multiplanar reformats, and three-dimensional (3D) postprocessing. Determination of image quality was based on a 4-point image quality rating (IQR) scale, ranging from 1 = nondiagnostic to 4 = excellent. Preoperative and intraoperative (n = 13) findings were correlated. Magnetic resonance (MR) examinations were generally well tolerated. Within the CT scan, 2 candidates presented moderate adverse reaction to the biliary contrast agent. MRI and CT showed the same benign parenchymal lesions (IQR MR: 3.7; IQR CT: 3.4). Determination of liver volumes was easier based on CT (IQR MR: 3.3; IQR CT: 3.6). Magnetic resonance angiography (MRA) revealed 10 variants of the arterial liver supply (IQR: 3.0) and computed tomographic angiography (CTA) revealed 13 variants (IQR: 3.5). Magnetic resonance cholangiopancreatography (MRCP) identified 4 biliary variants (IQR: 1.3) and CT cholangiography identified 17 (IQR: 3.5). MRI and CT each showed 4 hepatic and portal venous variants (IQR MR: 3.4, CT: 2.8). CT and MR findings correlated well with intraoperative findings. In conclusion, both techniques proved to be efficient to evaluate potential living liver donors' anatomy in a single diagnostic step. The main advantage of CT lies in the ability to accurately assess the biliary anatomy.