Dynamic-contrast-enhanced magnetic resonance imaging of cirrhotic liver parenchyma: A comparison between gadolinium-diethylenetriamine pentaacetic acid and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid.
BACKGROUND
The newly developed magnetic-resonance-imaging (MRI) hepatocyte-specific contrast agent, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), has different excretion pathways from the conventional MRI contrast agent, gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). In this study, we compare the enhancement effect of the liver and renal parenchyma between these two contrast agents for patients with liver cirrhosis.


METHODS
We retrospectively included 49 consecutive patients with liver cirrhosis who underwent Gd-DTPA- and Gd-EOB-DTPA-enhanced MRIs within 3 months. We measured the signal intensity of the liver and kidney, and calculated the enhancement ratio (ER) in the arterial phase, portal venous phase, and venous phase (VP). We also calculated a delayed phase (DP) when Gd-DTPA was used, and a hepatocyte phase (HP) when Gd-EOB-DTPA was used. The ERs were compared between the two contrast agents. The effect of liver function on the ERs was also evaluated.


RESULTS
The ER of the liver with Gd-EOB-DTPA was significantly higher than with Gd-DTPA in the VP (p = 0.01) and in the HP/DP (p = 0.01). The ER of the kidney in the DP with Gd-DTPA was significantly higher than in the HP with Gd-EOB-DTPA (p < 0.001). The ERs of the liver using Gd-EOB-DTPA for patients with normal serum bilirubin were significantly higher than those with abnormal levels (p = 0.047), but there was no significant difference using Gd-DTPA.


CONCLUSIONS
The enhancement effect of the liver parenchyma using both MRI contrast agents was not affected by the degree of liver cirrhosis or abnormal liver function. However, it was affected by the serum-bilirubin levels in the Gd-EOB-DTPA-enhanced MRIs. Furthermore, enhancement of the liver was higher when using Gd-EOB-DTPA in the VP, DP, and HP. This knowledge is helpful when performing dynamic MRIs to diagnose focal hepatic lesions in the heterogeneous liver parenchyma.
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University Hospital, Yilan, Taiwan, ROC.
Chun-Yi
CY
Lin
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Wei-Chou
WC
Chang
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan, ROC.
Chen-Te
CT
Chou
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Taipei City Hospital, Taipei, Taiwan, ROC. Electronic address: chenranchou@yahoo.com.tw.
Ran-Chou
RC
Chen
D000328:Adult; D001663:Bilirubin / Q000097:blood; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA; D001663:Bilirubin
Gd–DTPA; Gd–EOB–DTPA; liver cirrhosis; magnetic resonance imaging