Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography.

AIMS: The aim of this study was to evaluate liver arteries to depict variations by using multidetector computed tomography (CT) in donor candidates for living related liver transplantation. METHODS: Computed tomographic hepatic angiography was carried out using a multidetector 16-row CT scanner (Sensation 16; Siemens) in 48 candidates between April 2003 and August 2004. Multidetector CT was performed after intravenous injection of 150 mL of contrast material at a rate of 4 mL/s. Arterial phase images were acquired after contrast injection. Afterward, maximum intensity projections and volume-rendered images were produced from the axial image data. Twenty-eight of these patients underwent conventional catheter angiography. RESULTS: Excellent arterial opacification was shown on multidetector CT scans in all patients; arteries up to tertiary branches were identified with CT. Of 28 patients who had both multidetector CT angiography and conventional angiography, only a branch of hepatic artery originating from superior mesenteric artery that supplied the posterior segment of the right lobe was not identified on multidetector CT angiography. In 27 donors, hepatic arterial anatomy depicted at multidetector CT angiography was identical to that at conventional angiography. We identified hepatic vascular variants in 22 of 48 patients with multidetector CT. The most common arterial variant was an accessory hepatic artery arising from the left gastric artery. CONCLUSIONS: Preoperative imaging evaluation of hepatic vascular anatomy is crucial for surgical planning in living related transplant donors. Multidetector CT is useful to depict hepatic arterial anatomy with high accuracy.

MR rectography evaluation of rectoceles with oral gadopentetate dimeglumine and polyethylene glycol solution.

BACKGROUND: We assessed the value of magnetic resonance (MR) rectography in diagnosing rectocele by using a combination of oral gadopentetate dimeglumine and polyethylene glycol solutions. METHODS: T1-weighted, breath-hold, fast low-angle shot sequences were made in 22 patients in resting and straining states in the supine position before and after administration of oral paramagnetic contrast. Twelve patients received polyethylene glycol solution in addition to contrast, and 10 received contrast only. The pubococcygeal line was the reference used for diagnostic measurements. The quality of each sequence was graded. Paired t test, chi-square test, and the Kolmogorov-Smirnov test were applied for statistical analysis. RESULTS: The results of noncontrast images were inconclusive. There was a statistically significant difference between MR imaging diagnosis of rectocele in patients in the straining position without and with contrast ( p < 0.05), and the difference was more prominent in patients using polyethylene glycol solution ( p < 0.001). Using oral contrast plus polyethylene glycol produced significantly better MR examinations in the resting and straining positions ( p < 0.05). CONCLUSION: The combination of oral contrast and polyethylene glycol solution improves the diagnostic value of MR rectography and is particularly useful when noncontrast examinations are inconclusive.