title: The value of gadoxetate disodium-enhanced MR imaging for predicting posthepatectomy liver failure after major hepatic resection: a preliminary study.
abstract: OBJECTIVE
  To investigate whether preoperative gadoxetate-disodium-enhanced MR imaging predicts posthepatectomy liver failure (PHLF) in patients who underwent major hepatic resection.
  
  
  METHODS
  Twenty nine patients who underwent preoperative gadoxetate-disodium-enhanced MR imaging and following major hepatic resection were enrolled. Hepatic parenchymal signal intensity (SI) on pre-contrast T1-weighted imaging and 20min hepatocyte phase was measured at each of the four liver segments by two observers using region of interest measurements. The mean value was calculated and used at each phase. The relative contrast enhancement index (RCEI) was calculated: (20min hepatocyte phase SI-pre-contrast SI)/pre-contrast SI. PHLF was determined by the International Study Group of Liver Surgery 2011 guidelines. Correlation analysis was performed between preoperative liver function test and RCEI. Diagnostic accuracy of RCEI for predicting PHLF was calculated with receiver operating characteristic curve analysis. The reproducibility of the RCEI measurement was evaluated.
  
  
  RESULTS
  There was a significant correlation between preoperative albumin (r=0.496, P=0.006), T-bilirubin (r=-0.383, P=0.041), and RCEI. Seven patients (24%) experienced PHLF, and one of these patients (3%) died. The diagnostic accuracy of RCEI was 0.838 (sensitivity 85.7%, specificity 77.3%, cut-off value: 0.7508, 95% confidence interval: 0.654, 0.947). The 95% limits of agreement and ICC between repeated RCEI measurements were 18.4% of the mean and 0.94, respectively, and between RCEI measurements by the two observers were 21.7% and 0.929, respectively.
  
  
  CONCLUSIONS
  Our results show that preoperative gadoxetate-disodium-enhanced MR imaging can predict PHLF in patients who underwent major hepatic resection.
authors: Department of Radiology, Daegu Fatima Hospital, Catholic University of Daegu, School of Medicine, 576-31 Sinam-dong, Dong-gu, Daegu 701-600, Republic of Korea. shcho2405@gmail.com
authors: Seung Hyun
authors: SH
authors: Cho
authors: Ung Rae
authors: UR
authors: Kang
authors: Joo Dong
authors: JD
authors: Kim
authors: Young Seok
authors: YS
authors: Han
authors: Dong Lak
authors: DL
authors: Choi
mesh_terms: D000328:Adult; D000368:Aged; D049448:Cholangiopancreatography, Magnetic Resonance; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D017093:Liver Failure / Q000175:diagnosis*; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA