Differentiation of healthy from cirrhotic livers. Evaluation of parametric images after contrast administration in magnetic resonance imaging.
OBJECTIVE
The authors describe a method to differentiate healthy from cirrhotic livers by the analysis of their behavior after paramagnetic contrast administration on magnetic resonance imaging.


METHODS
A dynamic single-slice spoiled-gradient recalled echo magnetic resonance imaging after contrast administration was performed on 67 patients (36 healthy livers and 31 cirrhotic livers). Three parametric images (averaged-enhancement, maximum-enhancement, and maximum-velocity) were reconstructed from the temporal dynamic images. Liver values were quantified by means of a region-of-interest procedure.


RESULTS
Relative averaged-enhancement and maximum-enhancement values were significantly different ( P < 0.05) between cirrhotic and normal livers. There was a significant correlation between the parametric values and the Child-Turcotte index of hepatic chronic insufficiency (P < 0.05).


CONCLUSIONS
Parametric images allow characterization of the signal-versus-time pixel-by-pixel variations in dynamic magnetic resonance imaging. The averaged-enhancement and maximum-enhancement values can be used to differentiate healthy from cirrhotic livers with accuracy. The higher values found in cirrhotic patients may reflect an overall increase in the amount of extracellular contrast present with respect to healthy livers. The degree of liver brightness in cirrhotic patients probably is related to an increased amount of interstitial space, an indirect measurement of hepatic necrosis.
Martí-Bonmatí
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Department of Diagnostic Radiology, Hospital Doctor Peset, Valencia, Spain. bonmati@san.gva.es
Masiá
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Casillas
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Ronchera-Oms
C L
CL
Torrijo
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C
D003287:Contrast Media / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007262:Infusions, Intravenous; D008099:Liver / Q000033:anatomy & histology*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D012189:Retrospective Studies
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA