Usefulness of 3D Contrast-enhanced Ultrasonic Cholangiography for Detecting Anatomical Variation of Biliary Tract in Living Liver Donors

  • Dr Rong-qin Zheng, Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, China
  • Dr Gui-hua Chen, Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, China
  • Dr Er-jiao Xu, Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, China
  • Dr Min-qiang Lu, Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, China
  • Dr Ren Mao, Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, China
  • Dr Jie Ren, Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, China
  • Dr Mei Liao, Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, China

    • Objective: To investigate the feasibility of three-dimensional contrast-enhanced ultrasonic cholangiography (3-D CEUSC) in detecting biliary anatomical variation in living liver donors.

    Methods: This study was approved by the institutional review board and written informed consent was obtained. From July 2008 to December 2008, 10 right hepatic lobe donors underwent 3-D CEUSC intra-operatively. The 3-D CEUSC images were obtained by administration of micro-bubble contrast mediums (SonoVue) into the bile ducts through cannula after open cholecystectomy. Two radiologist in consesus prospectively reviewed all the images for biliary tract variation according to Blumgart's classification and compared them with intra-operative cholangiography and surgical findings.

    Results: Biliary anatomy was visualized with 3-D CEUSC in all ten patients. Prospective analysis detected a type C1 variant and a type B variant in two donors according to Blumgart's classification, the other eight are classified as type A(normal anatomy). All the 3-D CEUSC findings on biliary anatomy were confirmed by intra-operative cholangiography and surgery findings.

    Conclusion: IO-3D-USC is a new method with the capacity to demonstrate spatial features of biliary tree, it may be an alternative to intra-operative cholangiography in detecting anatomical variations of biliary tract in living liver donors.