Timing bolus dynamic contrast-enhanced (DCE) MRI assessment of hepatic perfusion: Initial experience.
OBJECTIVE
To assess whether dynamic contrast-enhanced (DCE) MRI timing bolus data from routine clinical examinations can be postprocessed to obtain hepatic perfusion parameters for diagnosing cirrhosis.


METHODS
We retrospectively identified 57 patients (22 with cirrhosis and 35 without cirrhosis) who underwent abdominal MRI, which included a low-dose (2 mL gadodiamide) timing bolus using a volumetric spoiled gradient echo T1-weighted sequence through the abdomen. Using a dual-input single-compartment model, the following perfusion parameters were measured: arterial, portal, and total blood flow; arterial fraction; mean transit time; and distribution volume. Those parameters were compared between patients with and without cirrhosis using t-tests. Receiver operating characteristic (ROC) curve analysis was used to identify the perfusion parameters that can best predict the presence of cirrhosis.


RESULTS
The hepatic arterial fraction, arterial flow, and distribution volume in patients with cirrhosis (27.7 +/- 8.3%, 44.8 +/- 14.1 mL/minute/100 g, and 16.3 +/- 4.5%, respectively) were significantly higher than those without cirrhosis (18.7 +/- 4.4%, 28.5 +/- 11.7 mL/minute/100 g, and 14.0 +/- 4.2%, respectively; P < 0.05 for all). ROC analysis showed arterial fraction as the best predictor of cirrhosis, with sensitivity of 73% and specificity of 86%.


CONCLUSIONS
Timing bolus DCE MR images from routine examinations can be postprocessed to yield potentially useful hepatic perfusion parameters.
Baxter
Simon
S
Department of Radiology, University of California, San Francisco, San Francisco, California, USA.
Wang
Zhen J
ZJ
Joe
Bonnie N
BN
Qayyum
Aliya
A
Taouli
Bachir
B
Yeh
Benjamin M
BM
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007275:Injections, Intravenous; D008099:Liver / Q000098:blood supply*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA