title: Hepatic necro-inflammation and elevated liver enzymes: evaluation with MRI perfusion imaging with gadoxetic acid in chronic hepatitis patients.
abstract: OBJECTIVE
  To evaluate liver necro-inflammation and function by using gadoxetic acid-enhanced dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with histological analysis as the reference standard.
  
  
  METHODS
  Seventy-nine subjects (21 healthy subjects; 58 chronic hepatitis patients) who received gadoxetic acid-enhanced DCE-MRI were divided into three subgroups: no (A0, n = 31), mild (A1, n = 27), and moderate-severe (A2-A3, n = 21) activities. Two DCE-MRI models were measured: (1) a dual-input single-compartment model to obtain absolute arterial, portal venous, and total blood flow, arterial fraction (ART), distribution volume, and mean transit time; (2) a curve analysis method to obtain peak, slope, and AUC (area under curve). The serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels also obtained. Statistical testing included Kruskal-Wallis tests for continuous data, Pearson's correlation tests, and multiple linear regression analyses.
  
  
  RESULTS
  Hepatic necro-inflammatory activity grades were significantly correlated with fibrotic stages, serum ALT level, ART and AUC. ART was helpful to predict the mild activity (≤ A1 versus >A1; Az = 0.728), whereas AUC could differentiate no activity from any activity (A0 versus >A0; Az = 0.703). Peak, slope and AUC were all associated with AST and ALT (p < 0.05).
  
  
  CONCLUSIONS
  Gadoxetic acid-enhanced DCE-MRI parameters may be used to evaluate the severity of hepatic necro-inflammation and function.
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: B-B
authors.initials: BB
authors.lastname: Chen
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China. Electronic address: joyhcy@gmail.com.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: C-W
authors.initials: CW
authors.lastname: Yu
authors.affiliation: Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: J-H
authors.initials: JH
authors.lastname: Kao
authors.affiliation: Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: H-S
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: P-C
authors.initials: PC
authors.lastname: Liang
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: S-Y
authors.initials: SY
authors.lastname: Wei
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: R-M
authors.initials: RM
authors.lastname: Hwang
authors.affiliation: Department of Medical Imaging and Radiology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
authors.forename: T T-F
authors.initials: TT
authors.lastname: Shih
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D002681:China / Q000453:epidemiology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006521:Hepatitis, Chronic / Q000201:enzymology* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000201:enzymology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D055420:Perfusion Imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D019786:Gadolinium DTPA