Double-Dose Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients With Chronic Liver Disease

作者：Motosugi Utaroh; Ichikawa Tomoaki^*; Sano Katsuhiro; Sou Hironobu; Onohara Kojiro; Muhi Ali; Kitamura Takatoshi; Amemiya Fumitake; Enomoto Nobuyuki; Matsuda Masanori; Asakawa Masami; Fujii Hideki; Araki Tsutomu

来源：Investigative Radiology, 2011, 46(2): 141-145.

DOI：10.1097/RLI.0b013e3181f9c487

• MR imaging
• gadoxetic-acid (gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid or gadoxetic acid)
• liver
• chronic liver disease
• hepatocellular carcinoma

Objectives: To determine the effect of double-dose gadoxetic-acid (Gd-EOB-DTPA) on lesion-liver contrast ratio in arterial-and hepatocyte-phase images and arterial-phase image quality in patients with chronic liver disease.
Materials and Methods: The ethics committee at our institute approved this study. This study included 28 patients (13 with Child-Pugh class A and 15 with class B) with 54 hepatocellular carcinomas. All patients received the standard Gd-EOB-DTPA dose (0.025 mmol/kg bodyweight) and double dose (0.050 mmol/kg bodyweight). The lesion-liver contrast ratio was evaluated in arterial-and hepatocyte-phase images. The artifacts in arterial-phase images were evaluated with a 4-point scale. Wilcoxon signed-rank test were used for comparisons.
Results: The hepatocyte-phase lesion-liver contrast ratio after the double dose was significantly higher than that after the standard dose in patients with Child-Pugh class B disease(standard dose vs. double dose; 0.20 +/- 0.16 vs. 0.25 +/- 0.17; P < 0.0001); however, the ratio after both the standard and double doses was equivalent in patients with Child-Pugh class A disease (0.35 +/- 0.18 vs. 0.35 +/- 0.14; P = 0.3038). The double dose significantly increased the arterial-phase lesion-liver contrast ratio (0.34 +/- 0.19 vs. 0.58 +/- 0.33; P < 0.0001). The artifacts in the arterial-phase images were more prominent after the standard dose (2.7 vs. 2.4 for reader 1, 2.8 vs. 2.4 for reader 2; P = 0.0195 and 0.0010).
Conclusions: Administration of double dose of Gd-EOB-DTPA provided better arterial enhancement of hepatocellular carcinomas in patients with chronic liver disease, and also improved the lesion-liver contrast in hepatocyte-phase images in patients with Child-Pugh class B disease.

• 出版日期2011-2