Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla

作者：Verloh N^*; Haimerl M; Zeman F; Schlabeck M; Barreiros A; Loss M; Schreyer A G; Stroszczynski C; Fellner C; Wiggermann P

来源：European Radiology, 2014, 24(5): 1013-1019.

DOI：10.1007/s00330-014-3108-y

• Magnetic resonance imaging
• Gd-EOB-DTPA
• Abdomen
• Liver
• Model for end-stage liver disease ( MELD)

Objectives The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score.
Methods A total of 121 patients with normal liver NLF; MELD score <= 10) and 29 patients with impaired liver ILF; MELD score > 10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores.
Results RE differed significantly (p <= 0.001) between patients with NLF (87.2 +/- 29.5 %) and patients with ILF (45.4 +/- 26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups.
Conclusion Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function.

• 出版日期2014-5