Abdominal cross-sectional imaging of the associating liver partition and portal vein ligation for staged hepatectomy procedure

Table 2 Institutional magnetic resonance imaging protocol with i.v. administration gadoxetic acid (0.025 mmol/kg at an injection rate of 1 mL/s) for evaluating associating liver partition and portal vein ligation for staged hepatectomy patients before and after surgery

Sequence	Weightening	Acquisition plane	Technical clues	Rationale in the preoperative phase	Rationale in the postoperative phase
Half fourier acquisition single-shot turbo spin echo/single shot fast spin echo	T2	Coronal, transverse	-	Ruling out signs of chronic liver disease, including splenomegaly and/or ascites. Detection of parenchymal low signal intensity in iron accumulation	Detection of perihepatic/abdominal collection and/or ascites
GE in-phase/out of-phase	T1	Transverse	Dual echo, breath hold sequence with slice thickness 6 mm	Characterization of fat-containing lesions. Detection of signal intensity patterns of liver steatosis or hemochromatosis	Evaluation of the postoperative status of liver parenchyma. Characterization of tumor recurrence
MRCP	T2	Radial coronal acquisition (2D) or oblique coronal (3D)	2D and/or 3D technique	Evaluation of anatomic variants complicating or contraindicating surgery. Assessing the Bismuth category of hilar cholangiocarcinoma	Assessment of biliary strictures (site, extent) and biliary dilation upstream
Dynamic study with fat saturated 3D GE	T1	Transverse	Thin slice thickness (3 mm). Baseline acquisition followed by early arterial, late arterial, venous and delayed phases	Detection and characterization of liver lesions	Detection and characterization of parenchymal abnormalities, including tumor recurrence
Single-shot echoplanar imaging	Diffusion	Transverse	b values 50 and 400 and 800 s/mm2 (1.5T) or 50 and 800 and 1200 s/mm2 (3.0T). Nominal acquisition time about 3 min (1.5T) and 4 min (3T)	Detection and characterization of smaller lesions (< 1 cm in size)	Detection of parenchymal/periportal edema. Detection and characterization of smaller lesions (< 1 cm in size)
Fat saturated Turbo spin echo	T2	Transverse	Respiratory triggered, with slice thickness 6 mm. Nominal acquisition time 1.50 min	Detection and characterization of liver lesions.	Detection of parenchymal/periportal edema. Detection and characterization of liver lesions. Assessment of collections
GE in-phase/out of-phase	T1	Transverse	Same sequence as (2), acquired in the hepatobiliary phase (15-20 min after contrast injection)	Detection and characterization of liver lesions	Detection and characterization of liver abnormalities
Fat saturated 3D GE	T1	Transverse	Same sequence as (4), with modified flip angle (35°) to increase lesion-to-parenchyma conspicuity. Acquired in the hepatobiliary phase
Contrast-enhanced	T1	Oblique coronal	Thin-slice (1 mm) fat saturated 3D fast low angle shot (FLASH) sequence acquired	Functional evaluation of biliary obstruction (if present)	Detection of active bile leakage. Functional assessment of bile duct strictures and patency of bilioenteric anastomosis
MRCP

GE: Gradient echo; MRCP: Magnetic resonance cholangiopancreatography.