Assessment of liver function in primary biliary cirrhosis using Gd-EOB-DTPA-enhanced liver MRI

作者：Nilsson Henrik^*; Blomqvist Lennart; Douglas Lena; Nordell Anders; Jonas Eduard

来源：Hepato Pancreato Biliary, 2010, 12(8): 567-576.

DOI：10.1111/j.1477-2574.2010.00223.x

• liver function
• MRI
• Gd-EOB-DTPA
• DHCE-MRI
• primary biliary cirrhosis

Objectives: Gd-EOB-DTPA (gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid) is a gadolinium-based hepatocyte-specific contrast agent for magnetic resonance imaging (MRI). The aim of this study was to determine whether the hepatic uptake and excretion of Gd-EOB-DTPA differ between patients with primary biliary cirrhosis (PBC) and healthy controls, and whether differences could be quantified.
Methods: Gd-EOB-DTPA-enhanced liver MRI was performed in 20 healthy volunteers and 12 patients with PBC. The uptake of Gd-EOB-DTPA was assessed using traditional semi-quantitative parameters (C(max), T(max) and T(1/2)), as well as model-free parameters derived after deconvolutional analysis (hepatic extraction fraction [HEF], input-relative blood flow [irBF] and mean transit time [MTT]). In each individual, all parameters were calculated for each liver segment and the median of the segmental values was used to define a global liver median (GLM).
Results: Although the PBC patients had relatively mild disease according to their Model for End-stage Liver Disease (MELD), Child-Pugh and Mayo risk scores, they had significantly lower HEF and shorter MTT values compared with the healthy controls. These differences significantly increased with increasing MELD and Child-Pugh scores.
Conclusions: Dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) has a potential role as an imaging-based liver function test. The high spatial resolution of MRI enables hepatic function to be assessed on segmental and sub-segmental levels.

• 出版日期2010-10