title: Dynamic gadoxetate-enhanced MRI for the assessment of total and segmental liver function and volume in primary sclerosing cholangitis.
abstract: OBJECTIVE
  To evaluate dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) for the assessment of global and segmental liver volume and function in patients with primary sclerosing cholangitis (PSC), and to explore the heterogeneous distribution of liver function in this patient group.
  
  
  METHODS
  Twelve patients with primary sclerosing cholangitis (PSC) and 20 healthy volunteers were examined using DHCE-MRI with Gd-EOB-DTPA. Segmental and total liver volume were calculated, and functional parameters (hepatic extraction fraction [HEF], input relative blood-flow [irBF], and mean transit time [MTT]) were calculated in each liver voxel using deconvolutional analysis. In each study subject, and incongruence score (IS) was constructed to describe the mismatch between segmental function and volume. Among patients, the liver function parameters were correlated to bile duct obstruction and to established scoring models for liver disease.
  
  
  RESULTS
  Liver function was significantly more heterogeneously distributed in the patient group (IS 1.0 versus 0.4). There were significant correlations between biliary obstruction and segmental functional parameters (HEF rho -0.24; irBF rho -0.45), and the Mayo risk score correlated significantly with the total liver extraction capacity of Gd-EOB-DTPA (rho -0.85).
  
  
  CONCLUSIONS
  The study demonstrates a new method to quantify total and segmental liver function using DHCE-MRI in patients with PSC.
authors.affiliation: Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Nilsson
authors.forename: Lennart
authors.initials: L
authors.lastname: Blomqvist
authors.forename: Lena
authors.initials: L
authors.lastname: Douglas
authors.forename: Anders
authors.initials: A
authors.lastname: Nordell
authors.forename: Hans
authors.initials: H
authors.lastname: Jacobsson
authors.forename: Karin
authors.initials: K
authors.lastname: Hagen
authors.forename: Annika
authors.initials: A
authors.lastname: Bergquist
authors.forename: Eduard
authors.initials: E
authors.lastname: Jonas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D015209:Cholangitis, Sclerosing / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: DHCE-MRI; Gd-EOB-DTPA; liver function; primary sclerosing cholangitis