Right lobe living donor liver transplantation: Preoperative evaluation of the donor with MR imaging

OBJECTIVE. The purpose of this study was to report our experience in preope rative evaluation of right hepatic lobe donors with a comprehensive MR exam ination and to compare abdominal MR images, MR cholangiograms, and MR angio grams with findings at surgery, intraoperative cholangiography, and digital subtraction angiography. MATERIALS AND METHODS, Twenty-eight right hepatic lobe donors underwent pre operative evaluation with MR imaging, MR cholangiography, and MR angiograph y. Two abdominal radiologists independently and randomly reviewed these stu dies. Points of assessment included focal and diffuse liver disease, calcul ation of right lobe volumes, depiction of the biliary tract and ductal anom alies, and depiction of the liver vasculature and vascular anomalies. Compa rison was made with intraoperative cholangiograms (n = 20) and digital subt raction angiograms (n = 28). RESULTS. MR imaging revealed and characterized focal liver lesions in eight of 28 patients. Calculated right lobe volumes agreed with surgically deter mined volumes within 7% for reviewer 1 and within 15% for reviewer 2. Intra hepatic bile ducts were depicted completely with MR cholangiography in 25 o f 28 patients and with intraoperative cholangiography in nine of 20 patient s. MR cholangiography revealed ductal anomalies in six patients. MR imaging and MR angiography depicted the portal veins more completely than digital subtraction angiography. MR imaging and MR angiography correctly excluded p ortal venous anomalies in all patients and revealed surgically confirmed ac cessory hepatic veins in six of 28 patients. Angiographically confirmed art erial anomalies were correctly detected in three of 28 patients by at least one reviewer on MR imaging and MR angiography. CONCLUSION. MR imaging, MR cholangiography, and MR angiography provide a co mprehensive, accurate means of evaluating donors for factors that may precl ude or complicate right hepatic lobe donation.