title: Hepatobiliary magnetic resonance imaging in patients with liver disease: correlation of liver enhancement with biochemical liver function tests.
abstract: OBJECTIVE
  To evaluate hepatobiliary magnetic resonance imaging (MRI) using Gd-EOB-DTPA in relation to various liver function tests in patients with liver disorders.
  
  
  METHODS
  Fifty-one patients with liver disease underwent Gd-EOB-DTPA-enhanced liver MRI. Based on region-of-interest (ROI) analysis, liver signal intensity was calculated using the spleen as reference tissue. Liver-spleen contrast ratio (LSCR) and relative liver enhancement (RLE) were calculated. Serum levels of total bilirubin, gamma glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), lactate dehydrogenase (LDH), serum albumin level (AL), prothrombin time (PT), creatinine (CR) as well as international normalised ratio (INR) and model for end-stage liver disease (MELD) score were tested for correlation with LSCR and RLE.
  
  
  RESULTS
  Pre-contrast LSCR values correlated with total bilirubin (r = -0.39; p = 0.005), GGT (r = -0.37; p = 0.009), AST (r = -0.38; p = 0.013), ALT (r = -0.29; p = 0.046), PT (r = 0.52; p < 0.001), GLDH (r = -0.55; p = 0.044), INR (r = -0.42; p = 0.003), and MELD Score (r = -0.53; p < 0.001). After administration of Gd-EOB-DTPA bilirubin (r = -0.45; p = 0.001), GGT (r = -0.40; p = 0.004), PT (r = 0.54; p < 0.001), AST (r = -0.46; p = 0.002), ALT (r = -0.31; p = 0.030), INR (r = -0.45; p = 0.001) and MELD Score (r = -0.56; p < 0.001) significantly correlated with LSCR. RLE correlated with bilirubin (r = -0.40; p = 0.004), AST (r = -0.38; p = 0.013), PT (r = 0.42; p = 0.003), GGT (r = -0.33; p = 0.020), INR (r = -0.36; p = 0.011) and MELD Score (r = -0.43; p = 0.003).
  
  
  CONCLUSIONS
  Liver-spleen contrast ratio and relative liver enhancement using Gd-EOB-DTPA correlate with a number of routinely used biochemical liver function tests, suggesting that hepatobiliary MRI may serve as a valuable biomarker for liver function. The strongest correlation with liver enhancement was found for the MELD Score.
  
  
  CONCLUSIONS
  • Relative enhancement (RLE) of Gd-EOB-DTPA is related to biochemical liver function tests. • Correlation of RLE with bilirubin, ALT, AST, GGT, INR and MELD Score is reverse. • The correlation of relative liver enhancement with prothrombin time is positive. • AST, ALT, GLDH, prothrombin time, INR and MELD Score correlate with pre-contrast liver-spleen contrast ratio. • Such biomarkers may help to evaluate liver function.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany, Guido.Kukuk@ukb.uni-bonn.de.
authors.forename: Guido M
authors.initials: GM
authors.lastname: Kukuk
authors.forename: Stephanie G
authors.initials: SG
authors.lastname: Schaefer
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Dariusch R
authors.initials: DR
authors.lastname: Hadizadeh
authors.forename: Samer
authors.initials: S
authors.lastname: Ezziddin
authors.forename: Ulrich
authors.initials: U
authors.lastname: Spengler
authors.forename: Hans H
authors.initials: HH
authors.lastname: Schild
authors.forename: Winfried A
authors.initials: WA
authors.lastname: Willinek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D005969:Glutamate Dehydrogenase / Q000097:blood; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008107:Liver Diseases / Q000097:blood / Q000473:pathology*; D008111:Liver Function Tests / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D012709:Serum Albumin; C073590:gadolinium ethoxybenzyl DTPA; D007770:L-Lactate Dehydrogenase; D005969:Glutamate Dehydrogenase; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D019786:Gadolinium DTPA; D001663:Bilirubin