title: MR liver imaging with Gd-EOB-DTPA: The need for different delay times of the hepatobiliary phase in patients with different liver function.
abstract: OBJECTIVE
  To determine the optimal hepatobiliary delay time after Gd-EOB-DTPA injection for lesion characterization in cirrhosis patients with different liver function.
  
  
  METHODS
  Ninety consecutive patients with liver cirrhosis who underwent Gd-EOB-DTPA-enhanced MRI for the evaluation of known or suspected focal liver lesions were enrolled in this retrospective study. The patients were divided into Child-Pugh A, B and C groups depending on their liver function through the Child-Pugh classification. Hepatobiliary phase images obtained at 5, 10, 15, and 20min were assessed in each group by the following items: parenchymal enhancement, contrast agent excretion into the bile ducts and ureter, and contrast- and signal-to-noise ratios for lesions.
  
  
  RESULTS
  In the Child-Pugh A group, parenchymal enhancement increased significantly from 5min to 15min (P<0.05), and stabilized at 20min (P=0.22). However, there was no significant difference in parenchymal enhancement among all of the hepatobiliary phases in the Child-Pugh B and C groups. The biliary contrast agent excretion was first observed before 20min in all of the patients in the Child-Pugh A group, at 20min in 4 patients (25%) in the Child-Pugh B group, and after 20min in 11 patients (78.6%) in the Child-Pugh C group. The numbers of patients whose urethral contrast agent excretion was first observed at 5min in the Child-Pugh A, B and C groups were 38 (63.3%), 12 (75.0%) and 11 (78.6%), respectively. The CNR of the lesions increased significantly (P<0.05), up to 15min after enhancement without a further increase at 20min in the Child-Pugh A group; however, no significant change was found from 5min to 20min in the Child-Pugh B and C groups. For the SNR of lesions, there was no significant difference at 5, 10, 15 and 20min in all of the groups.
  
  
  CONCLUSIONS
  A delay time of 15min for the hepatobiliary phase was sufficient for patients with mild liver dysfunction who were classified as Child-Pugh A. Nevertheless, for the patients with moderate or severe liver dysfunction who were classified as Child-Pugh B or C, a delay time longer than 5min is meaningless for lesion characterization.
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Minglong
authors: M
authors: Liang
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Jun
authors: J
authors: Zhao
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Bing
authors: B
authors: Xie
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Chuanming
authors: C
authors: Li
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Xuntao
authors: X
authors: Yin
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Lin
authors: L
authors: Cheng
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China. Electronic address: wangjian_811@yahoo.com.
authors: Jian
authors: J
authors: Wang
authors: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China. Electronic address: linzhangswh@yahoo.com.
authors: Lin
authors: L
authors: Zhang
mesh_terms: D001652:Bile Ducts / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000503:physiopathology; D008107:Liver Diseases / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D059629:Signal-To-Noise Ratio; D013997:Time Factors
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Delay time; Gd-EOB-DTPA; Hepatobiliary phase; Liver cirrhosis