Assessment of liver function in primary biliary cirrhosis using Gd-EOB-DTPA-enhanced liver MRI.
OBJECTIVE
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.
Nilsson
Henrik
H
Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden. henrik.nilsson@ki.se
Blomqvist
Lennart
L
Douglas
Lena
L
Nordell
Anders
A
Jonas
Eduard
E
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008099:Liver / Q000098:blood supply / Q000503:physiopathology*; D008102:Liver Circulation; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis* / Q000503:physiopathology; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013548:Sweden; D013997:Time Factors
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA