Comparison between non-contrast-enhanced MRA and contrast-enhanced CTA in the assessment of hepatic arterial vasculature of donors before liver transplantation

Abstract Background Radiologic evaluation is crucial in minimizing transplant complications and guaranteeing the donor’s safety, as a variety of anatomical variations characterizes hepatic vascularity. Computed tomographic angiography (CTA) is the gold standard in hepatic vascularity evaluation in donors before liver transplantation. Still, the procedure necessitates intravenous contrast medium injection, which entails nephrotoxicity risk and hypersensitivity reactions. These concerns about contrast medium safety encouraged new developments in non-contrast-enhanced magnetic resonance angiography (NC-MRA) techniques for imaging the vascular anatomy of the liver. Results This study was conducted on 40 patients of potential liver donors. Thirty-six cases (90%) showed excellent image quality by CTA versus 14 cases (35%) by NC-MRA; on the other hand, 21 cases (52.5%) showed good image quality by NC-MRA while versus 2 cases (5%) by CTA and NC-MRA documented 5 cases (12.5%) with fair image quality versus two cases documented by CTA. Both modalities provided diagnostic image quality in all cases. Michel’s classification was employed to identify four distinct kinds of hepatic artery anatomy using CTA. Thirty-nine cases out of 40 were successfully identified using NC-MRA. Segment IV hepatic artery origin could not be identified in 6 cases using NC-MRA versus one case using CTA. Artifacts were noted in 20 cases (50%) using NC-MRA versus 2 cases (5%) using CTA. Conclusion CTA is the gold standard for pre-liver transplant donor evaluation. The emerging technology of non-contrast MRA has an added value with fewer patient complications. It may function as an additional donor examination when CTA is unable to provide adequate diagnostic information. Non-contrast MRA yields reliable results and eliminates the necessity for contrast medium and additional radiation exposure.