European journal of radiology · 2025
Comparison of dual arterial phase gadoxetic acid enhanced MRA with CTA for depiction of hepatic vasculature in potential liver donor candidates.
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Serrao Eva Mendes, Odreda Devang, Basso-Dias Adriano, Li Xuan, Kashani Hany, Prasla Shopnil, Malik Shamir, Cattral Mark, Jhaveri Kartik
Аннотация
OBJECTIVE: To determine the ability of dual-arterial phase gadoxetic acid-enhanced CAIPIRINHA MRI in preoperative assessment of hepatic vasculature in potential living liver donors with CTA as the reference standard.
METHODS: In this ethics board approved retrospective study, 81 consecutive living liver donor candidates (31 men, 50 women; mean age 37 years, range 22-58 years) with preoperative CTA and MRA were included. Study cohort subjects had undergone liver CT and MRI as per the standard departmental liver donor protocols. MRI protocol included dual arterial phase CAIPIRINHA acquisitions following gadoxetic acid administration. Two independent blinded radiologists reviewed MRA images for 1) image quality and confidence scores in identifying hepatic vasculature and 2) inter-modality agreement in characterizing hepatic vascular variants, with consensus CTA readings as the reference standard. Statistical analysis was performed to determine the accuracy of MRI for determination of variant hepatic vasculature in reference to CTA.
RESULTS: The MRI accuracy for depicting hepatic arterial, segment IV arterial origin, portal, and hepatic venous variants was 0.78, 0.5, 0.9, and 0.6, respectively, compared to CTA. While MR scans exhibited overall excellent diagnostic quality, subjective image quality for hepatic artery depiction in MRA was significantly lower than in CTA (p < 0.001). Most arterial variants were well identified on MRA, except for types 5 and 11. Incorrect determination of Segment IV artery origin was the most frequent error with MRA. Portal venous anatomy was well characterized by both MRA and CTA, except for types 2 and 3. MRI exhibited inconsistency in accurately characterizing type 2 and 5 hepatic venous variants.
CONCLUSION: CAIPIRINHA protocol-enabled dual-arterial multiphase gadoxetic acid-enhanced MRI presents an alternative approach for evaluating hepatic vascular anatomy in potential liver donors compared to CTA. However, due to its limitations in assessing anatomical variations of the hepatic arterial vasculature particularly the origin of segment IV artery, absolute replacement of CTA with MRA as the primary imaging modality is currently not justifiable.
METHODS: In this ethics board approved retrospective study, 81 consecutive living liver donor candidates (31 men, 50 women; mean age 37 years, range 22-58 years) with preoperative CTA and MRA were included. Study cohort subjects had undergone liver CT and MRI as per the standard departmental liver donor protocols. MRI protocol included dual arterial phase CAIPIRINHA acquisitions following gadoxetic acid administration. Two independent blinded radiologists reviewed MRA images for 1) image quality and confidence scores in identifying hepatic vasculature and 2) inter-modality agreement in characterizing hepatic vascular variants, with consensus CTA readings as the reference standard. Statistical analysis was performed to determine the accuracy of MRI for determination of variant hepatic vasculature in reference to CTA.
RESULTS: The MRI accuracy for depicting hepatic arterial, segment IV arterial origin, portal, and hepatic venous variants was 0.78, 0.5, 0.9, and 0.6, respectively, compared to CTA. While MR scans exhibited overall excellent diagnostic quality, subjective image quality for hepatic artery depiction in MRA was significantly lower than in CTA (p < 0.001). Most arterial variants were well identified on MRA, except for types 5 and 11. Incorrect determination of Segment IV artery origin was the most frequent error with MRA. Portal venous anatomy was well characterized by both MRA and CTA, except for types 2 and 3. MRI exhibited inconsistency in accurately characterizing type 2 and 5 hepatic venous variants.
CONCLUSION: CAIPIRINHA protocol-enabled dual-arterial multiphase gadoxetic acid-enhanced MRI presents an alternative approach for evaluating hepatic vascular anatomy in potential liver donors compared to CTA. However, due to its limitations in assessing anatomical variations of the hepatic arterial vasculature particularly the origin of segment IV artery, absolute replacement of CTA with MRA as the primary imaging modality is currently not justifiable.