Background: Biliary anatomy and its common and uncommon variations are of considerable clinical significance when performing living donor transplantation, radiological interventions in hepatobiliary system, laparoscopic cholecystectomy, and liver resection (hepatectomy, segmentectomy). Because of increasing trend found in the number of liver transplant surgeries being performed, magnetic resonance cholangiopancreatography (MRCP) has become the modality of choice for noninvasive evaluation of abnormalities of the biliary tract. The aim of this study is to determine the anatomic variations of the intrahepatic biliary tree of the right liver lobe using MRCP.
Methods: The study included 80 retrospectively evaluated participants that had undergone MRCP. All examinations were performed with on 3T magnetic resonance imaging (MRI) scanner (GE Discovery MR750W) of the State Second Central Hospital. We routinely acquire coronal and axial T2-weighted (T2W) single-shot fast spin-echo (FSE) sequences. MRCP is performed by using a respiratory-triggered high-spatial-resolution isotropic three-dimensional fast-recovery FSE sequence with parallel imaging in axial and oblique coronal planes, which provides high signal-to noise ratio and excellent spatial resolution (1-mm isotropic voxels).
Results: Our study group comprised 46 (57.5%) female and 34 (42.5%) male patients. Mean age of the patients was 46,7±40.3 years (mean±standard deviation). Branching pattern in the right biliary ductal system: typical right posterior sectoral duct (RPSD) joining right anterior sectoral duct (RASD) medially to form right hepatic duct (type I) in 50 cases (62.5%) of the patients. Trifurcation: simultaneous emptying of the RASD, RPSD, and left hepatic duct (LHD) into the common hepatic duct (CHD) (type II) was identified in 13 cases (16.25%). Anomalous drainage of RPSD: RPSD joining LHD (type IIIa) in five cases (6.25%), RPSD joining CHD (type IIIb) in 10 cases (12.5%) and RPSD joining cystic duct (type IIIc) in two cases (2.5%) of all participants were noted, respectively.
Conclusions: Typical RPSD joining RASD medially to form RHD (type I) was commonly identified in all cases of the patients.