title: Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases.
abstract: OBJECTIVE
  To assess whether reticular hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) is a diagnostic finding of sinusoidal obstruction syndrome (SOS) in patients with hepatic metastases who have undergone chemotherapy.
  
  
  METHODS
  We retrospectively analysed EOB-MRI of 42 patients who had undergone chemotherapy before hepatic resection of colorectal hepatic metastases. Two radiologists, who were unaware of whether or not the patients had SOS, reviewed the hepatobiliary phase images to determine the presence of hypointense reticulation in the liver using a 5-point scale. The sensitivity, specificity and area under the receiver operating characteristics curve (A(z)) were calculated for each reviewer.
  
  
  RESULTS
  The sensitivity, specificity and A(z) for the diagnosis of SOS were 75%, 100% and 0.957 for reader 1 and 75%, 96.2% and 0.936 for reader 2, respectively. In one patient who received a false-positive diagnosis by one reader, there was sinusoidal fibrosis on histological examination, but not diagnostic for SOS. False-negative diagnosis occurred in four patients for both readers; histology of these patients showed minimal and localised sinusoidal congestion and fibrosis.
  
  
  CONCLUSIONS
  Reticular hypointensity on hepatobiliary phase images of EOB-MRI is highly specific for the diagnosis of SOS in patients with treated colorectal hepatic metastases.
  
  
  CONCLUSIONS
  Gadoxetic acid enhanced magnetic resonance imaging (EOB-MRI) can identify the sinusoidal obstruction syndrome (SOS). The diagnosis can be achieved with high specificity and good interobserver agreement. SOS typically demonstrates diffuse hypointensity on hepatobiliary phase images on EOB-MRI. EOB-MRI may be falsely negative in patients with minimal degree of SOS.
authors: Department of Radiology, Yonsei University Severance Hospital, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
authors: Na-Young
authors: NY
authors: Shin
authors: Myeong-Jin
authors: MJ
authors: Kim
authors: Joon Seok
authors: JS
authors: Lim
authors: Mi-Suk
authors: MS
authors: Park
authors: Yong-Eun
authors: YE
authors: Chung
authors: Jin-Young
authors: JY
authors: Choi
authors: Ki Whang
authors: KW
authors: Kim
authors: Young-Nyun
authors: YN
authors: Park
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006504:Hepatic Veno-Occlusive Disease / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA