HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text All Versions of this Article: 2382050133v1 238/3/900    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schroeder, T. Articles by Ruehm, S. G. Search for Related Content PubMed PubMed Citation Articles by Schroeder, T. Articles by Ruehm, S. G.

Evaluation of Living Liver Donors with an All-inclusive 3D Multi–Detector Row CT Protocol¹

¹ From the Department of Diagnostic and Interventional Radiology (T.S., H.K.) and Department of General Surgery and Transplantation (A.R., M.M.), University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany; University Hospital Eppendorf, Hamburg, Germany (J.F.D.); and Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, Calif (S.G.R.). Received January 27, 2005; revision requested March 31; revision received April 15; accepted May 19; manuscript final version approval May 31. Supported in part by the German Research Society, Bonn, Germany, Grant KFO 117/1-1;A2.2. Address correspondence to T.S. (e-mail: Tobias.Schroeder{at}uni-essen.de).

Purpose: To prospectively assess parenchymal, vascular, and biliary anatomy of potential living liver donors with an all-inclusive multi–detector row computed tomographic (CT) approach.

Materials and Methods: A total of 250 potential living liver donors (112 women, 138 men; mean age, 37 years) underwent three-phase, dual-enhancement multi–detector row CT to delineate biliary, vascular, and parenchymal morphology according to an institutional review board–approved protocol. Informed consent was obtained from all subjects. For display of the biliary system, the first CT image set was collected after the infusion of a biliary contrast agent. CT angiography was subsequently performed, after automated injection of a conventional iodinated contrast agent, to display the arterial and portal-hepatic venous systems. All data sets were reconstructed in 1-mm sections. Data analysis was based on source images, multiplanar reconstructions, and three-dimensional postprocessing images; was performed in consensus by two radiologists; and was focused on the detection of biliary and vascular variants, exclusion of focal liver lesions, and determination of hepatic volumes. Preoperative findings were correlated with intraoperative findings (available in 62 subjects).

Results: Technical failures were experienced in 10 of 250 examinations. Twenty-seven subjects had moderate adverse reactions related to the biliary contrast agent. Benign hepatic lesions were detected in 61 candidates; one candidate had a renal cell carcinoma. Underlying biliary and vascular anatomy was displayed at least to the second intrahepatic branch in all but seven patients. Detected anatomic variants involved the biliary (38.8%), arterial (40.0%), portal venous (21.4%), and hepatic venous (43.5%) systems. Correlation with intraoperative findings was excellent. Some biliary (n = 4), arterial (n = 5), portal venous (n = 1), and hepatic venous (n = 6) variants were missed or misinterpreted at initial reading of preoperative data; however, variants could be retrospectively depicted in all but one biliary case and one hepatic venous case.

Conclusion: The outlined three-phase, dual-enhancement multi–detector row CT protocol represents an all-inclusive approach to evaluate potential living liver donors in a single diagnostic step.

© RSNA, 2006

This article has been cited by other articles:

				R. S. Breiman, F. V. Coakley, E. M. Webb, J. J. Ellingson, J. P. Roberts, J. Kohr, J. Lutz, N. Knoess, and B. M. Yeh CT Cholangiography in Potential Liver Donors: Effect of Premedication with Intravenous Morphine on Biliary Caliber and Visualization Radiology, June 1, 2008; 247(3): 733 - 737. [Abstract] [Full Text] [PDF]

				C. Heilmaier, R. Sutter, A. M. Lutz, B. Seifert, D. Weishaupt, B. Marincek, and J. K. Willmann Mapping of Hepatic Vascular Anatomy: Dynamic Contrast-enhanced Parallel MR Imaging Compared with 64 Detector Row CT Radiology, December 1, 2007; 245(3): 872 - 880. [Abstract] [Full Text] [PDF]

				B. M. Yeh, F. V. Coakley, A. C. Westphalen, B. N. Joe, C. E. Freise, A. Qayyum, R. A. McTaggart, and J. P. Roberts Predicting Biliary Complications in Right Lobe Liver Transplant Recipients according to Distance between Donor's Bile Duct and Corresponding Hepatic Artery Radiology, January 1, 2007; 242(1): 144 - 151. [Abstract] [Full Text] [PDF]