Importance of Imaging Plane of Gadoxetic Acid-Enhanced Magnetic Resonance Cholangiography for Bile Duct Anatomy in Healthy Liver Donors

Abstract

Purpose. The purpose of this study was to compare the image quality and accuracy of axial vs coronal contrast-enhanced magnetic resonance cholangiography (CE-MRC) for assessing bile duct anatomy.

Methods. Data from 313 healthy donors who underwent axial and coronal CE-MRC before liver donation were retrospectively analyzed. Motion artifacts and bile duct visibility were assessed using 4-point scales, with scores similar to 3 considered interpretable. The sensitivity and specificity of axial and coronal CE-MRC for diagnosing anatomic variations were compared, as were the proportions of correctly categorized biliary anatomic types.

Results. Axial CE-MRC provided better image quality than coronal CE-MRC in terms of both motion artifacts (3.83 vs 3.17; P <.001) and duct visibility (3.50 vs 3.17, P <.001), resulting in more interpretable images with axial than coronal CE-MRC (92.7% vs 82.1%; P <.001). Among 249 donors with interpretable images, coronal CE-MRC performed significantly better for identifying duct anatomic variation than axial CE-MRC (sensitivity, 96.9% vs 80.4%, P <.001; specificity, 100% vs 96.7%, P = .025). Coronal CE-MRC was significantly better than axial CE-MRC at correctly categorizing anatomic types of right posterior hepatic duct into left hepatic duct and accessory duct with incomplete right hepatic duct.

Conclusions. With interpretable image quality, coronal CE-MRC performed better than axial CE-MRC for evaluating bile duct anatomy.