Magnetic resonance angiographic inflow-sensitive inversion recovery technique for vascular evaluation before liver transplantation

Background: The recipient's hepatic vascular anatomy is essential in living-donor liver transplantation (LDLT). Magnetic resonance angiographic inflow-sensitive inversion recovery (IFIR-MRA) is a new noncontrast technology for vascular evaluation, particularly for those patients with renal function impairment. The purpose of this study was to improve the image quality with different blood suppression inversion time (BSP TI) settings.

Methods: From October 2012 to March 2013, 21 recipient candidates underwent IFIR-MRA with the use of the GE 1.5T-Discovery 450 for LDLT preoperation evaluation with different BSP TI settings. Subjective visualized image quality and depiction of hepatic arteries, portal veins, and inferior vena cava (IVC) were all evaluated on a vessel-to-vessel basis. A paired t test analysis was used to assess the difference in grading scales between the different BSP TI settings in IFIR-MRA.

Results: The 21 recipients (4 female, 17 male) had a mean age of 53.43 ± 11.07 years. A significant difference (P < .001) existed in the arterial depiction scores between BSP TI 1,000 ms (3.10 ± 0.70) and BSP TI 1,400 ms (3.57 ± 0.7). There were no significant differences of quality scores in artery (3.71 ± 0.56 vs 3.48 ± 0.60), portal vein (3.57 ± 0.60 vs 3.48 ± 0.51), and IVC (2.71 ± 1.19 vs 2.76 ± 1.09), and no significant differences of depiction scores in portal vein (2.29 ± 0.46 vs 2.48 ± 0.51) and IVC (1.57 ± 0.68 vs 1.62 ± 0.15).

Conclusions: The images with BSP TI 1,400 ms were the most optimal for IFIR noncontrast MRA imaging in LDLT. This new technology can replace traditional contrast-enhanced MRA, especially for patients with renal function impairment.