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Abstract：
BACKGROUND: Detailed knowledge of the biliary anatomy is essential to avoid complications in living donor liver transplantation. The aim of this study was to determine the optimal dosage of Gd-EOB-DTPA for contrast-enhanced magnetic resonance cholangiography (ce-MRC) with reference to contrast-enhanced CT cholangiography (ce-CTC).
METHODS: 30 potential living liver donors (PLLD) underwent both ce-CTC and ce-MRC. Ten candidates each received single, double or half-dose Gd-EOB-DTPA. Ce-MRC images with and without inversion recovery pulses (T1w±IR) were acquired 20-30min after intravenous contrast injection. Image data was quantitatively and qualitatively reviewed by two radiologists based on a on a 5-point scale. Data sets were compared using a Mann-Whitney-U-test or Wilcoxon-rank-sum-test. Kappa values were also calculated.
RESULTS: All image series provided sufficient diagnostic information both showing normal biliary anatomy and variant bile ducts. Ce-CTC showed statistically significant better results compared to all ce-MRC data sets. T1w MRC with single dose Gd-EOB-DTPA proved to be superior to half and double dose in subjective and objective evaluation without a statistically significant difference.
CONCLUSIONS: Ce-MRC is at any dosage inferior to ce-CTC. As far as preoperative planning of bile duct surgery is focused on the central biliary anatomy, ce-MRC can replace harmful ce-CTC strategies, anyway. Best results were seen with single dose GD-EOB-DTPA on T1w MRC+IR.
METHODS: 30 potential living liver donors (PLLD) underwent both ce-CTC and ce-MRC. Ten candidates each received single, double or half-dose Gd-EOB-DTPA. Ce-MRC images with and without inversion recovery pulses (T1w±IR) were acquired 20-30min after intravenous contrast injection. Image data was quantitatively and qualitatively reviewed by two radiologists based on a on a 5-point scale. Data sets were compared using a Mann-Whitney-U-test or Wilcoxon-rank-sum-test. Kappa values were also calculated.
RESULTS: All image series provided sufficient diagnostic information both showing normal biliary anatomy and variant bile ducts. Ce-CTC showed statistically significant better results compared to all ce-MRC data sets. T1w MRC with single dose Gd-EOB-DTPA proved to be superior to half and double dose in subjective and objective evaluation without a statistically significant difference.
CONCLUSIONS: Ce-MRC is at any dosage inferior to ce-CTC. As far as preoperative planning of bile duct surgery is focused on the central biliary anatomy, ce-MRC can replace harmful ce-CTC strategies, anyway. Best results were seen with single dose GD-EOB-DTPA on T1w MRC+IR.
摘要：
背景：详细了解胆道解剖对于避免活体肝移植的并发症至关重要。这项研究的目的是参考对比增强CT胆管造影（ce-CTC），确定Gd-EOB-DTPA用于对比增强磁共振胆管造影（ce-MRC）的最佳剂量。
方法：30名潜在的活体肝脏供体（PLLD）同时接受了ce-CTC和ce-MRC。十名候选人每人获得单身，双剂量或半剂量Gd-EOB-DTPA。在静脉内造影剂注射后20-30分钟获取具有和不具有反转恢复脉冲(T1w±IR)的Ce-MRC图像。两位放射科医生基于5分制对图像数据进行了定量和定性审查。使用Mann-Whitney-U检验或Wilcoxon秩和检验比较数据集。还计算了Kappa值。
结果：所有图像系列都提供了足够的诊断信息，显示了正常的胆道解剖结构和变异的胆管。与所有ce-MRC数据集相比，Ce-CTC显示出统计学上较好的结果。单剂量Gd-EOB-DTPA的T1wMRC在主观和客观评估中被证明优于半剂量和双倍剂量，无统计学差异。
结论：Ce-MRC在任何剂量下都不如ce-CTC。就胆管手术的术前计划而言，主要集中在中央胆管解剖上。CE-MRC可以取代有害的CE-CTC策略，无论如何。使用单剂量GD-EOB-DTPA在T1wMRC+IR上观察到最佳结果。
方法：30名潜在的活体肝脏供体（PLLD）同时接受了ce-CTC和ce-MRC。十名候选人每人获得单身，双剂量或半剂量Gd-EOB-DTPA。在静脉内造影剂注射后20-30分钟获取具有和不具有反转恢复脉冲(T1w±IR)的Ce-MRC图像。两位放射科医生基于5分制对图像数据进行了定量和定性审查。使用Mann-Whitney-U检验或Wilcoxon秩和检验比较数据集。还计算了Kappa值。
结果：所有图像系列都提供了足够的诊断信息，显示了正常的胆道解剖结构和变异的胆管。与所有ce-MRC数据集相比，Ce-CTC显示出统计学上较好的结果。单剂量Gd-EOB-DTPA的T1wMRC在主观和客观评估中被证明优于半剂量和双倍剂量，无统计学差异。
结论：Ce-MRC在任何剂量下都不如ce-CTC。就胆管手术的术前计划而言，主要集中在中央胆管解剖上。CE-MRC可以取代有害的CE-CTC策略，无论如何。使用单剂量GD-EOB-DTPA在T1wMRC+IR上观察到最佳结果。
