Application Of Inflow Inversion Recovery Sequence In Angiography Of Liver Transplantation

BackgroundCurrently,liver transplantation is considered to be the most effective treatment for end-stage liver disease.In recent years,with the development of liver transplantation surgery and immunosuppression,which have resulted in increased patient and graft survival.However,a worldwide shortage of donor organs lead to transplant hepatologists and patients have higher requirements and expectations for the success rate of surgery.Therefore,transplant hepatologists need to accurately evaluate the liver vascular anatomy and variation of the donor and recipient on preoperative liver transplantation,which is crucial to improve the success rate of surgery.The effective evaluation and management of early postoperative vascular complication is conducive to improving the survival rate of patients and grafts.There are many techniques of liver angiography,which have their own advantages and disadvantages.It has become a highlight of medical researchers to find a non-invasive,non-contrast,non-ionized radiation,simple operation,low cost,safe and reliable liver angiography technique.ObjectiveTo explore the application value of inflow inversion recovery sequence in angiography of liver transplantation.Methods1.31 patients needed to be going abdominal contrast-enhanced magnetic resonance angiography(CE-MRA)before liver transplantation were enrolled in the study,and 31 patients underwent coronal inflow inversion recovery sequence(IFIR)and CE-MRA.Two radiologists with more than 10 years' working experience scored the image quality of hepatic artery of the two groups and evaluated the difference of the grade of the largest branch of hepatic artery by blind.To compare the consistency of the image quality score of the hepatic artery at all levels and the difference of the maximum display branch level between the IFIR group and the CE-MRA group.To evaluate the consistency of image quality score between radiologists and the level of maximum branch of hepatic artery.2.IFIR and contrast-enhanced MRA were performed in 26 patients of liver transplant postoperative.Two radiologists scored the portal vein display quality of two groups of images,and compared the difference of image scores between the two groups.Two radiologists independently measured the diameter of anastomotic stoma in two groups of portal vein images and compared the difference of image measurement values between the two groups.To evaluate the consistency of image quality score and anastomotic diameter between 2 radiologists.Results1.In 31 patients with celiac trunk,common hepatic artery,proper hepatic artery,right hepatic artery and left hepatic artery in IFIR group and CE-MRA image quality scored by 2 radiologists,which had no significant differences(P > 0.05).There was significant difference in image quality scores between right anterior hepatic artery,right posterior hepatic artery,left internal hepatic artery and left lateral hepatic artery(P < 0.05).The consistency of image quality score between 2 radiologists was above grade 3.Among the 31 patients,3 cases of hepatic artery variation were found in the IFIR group and CE-MRA group,1 case of right hepatic artery originated from superior mesenteric artery and left hepatic artery started from splenic artery.In 1 case,the congenital development of common hepatic artery was small,and the two methods were not clear.1 case of right hepatic artery originated from the celiac trunk.The right hepatic artery was tortuous in 1case.Since the left hepatic lobectomy was performed in 2 patients,the left hepatic artery and its secondary arteries were not shown.2.In IFIR and CE-MRA,the main portal vein,left and right branches of the portal vein were displayed in 26 patients,and the image quality score ? 3 points was 92.31%(24/26)and 96.15%(25/26)respectively.There was no significant difference of image quality score of IFIR sequence and CE-MRA evaluated by 2 radiologists(radiologist 1:Z=-1.077,P=0.282;radiologist 2: Z=-0.629,P=0.529),nor of the measured diameter of anastomosis between IFIR sequence and CE-MRA(radiologist 1: t=0.369,P=0.546,radiologist 2: t=0.020,P=0.889).The consistency of image quality scores and anastomotic diameters evaluated by 2 radiologists was good.Conclusions1.IFIR sequence is a non-invasive,radiation-free,non-contrast and without breath-holding magnetic resonance angiography technique,which has certain clinical value in evaluating the anatomic structure and variation of hepatic artery before liver transplantation.2.IFIR sequence is a non-invasive,radiation-free and non-contrast magnetic resonance portal vein angiography technique,which can be used as one of the effective methods of portal vein tracking and management after liver transplantation.