MRI of the liver: choosing the right contrast agent

• Published in: Abdominal imaging Vol. 45; no. 2; pp. 384 - 392
• Main Authors: Welle, Christopher L., Guglielmo, Flavius F., Venkatesh, Sudhakar K.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2020; Springer Nature B.V
• Subjects: Contrast agents; Contrast Media; Gastroenterology; Hepatocytes; Hepatology; Humans; Image Enhancement; Imaging; Intravenous administration; Lesions; Liver; Liver diseases; Liver Diseases - diagnostic imaging; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Radiology; Review; Gadoxetate disodium; Biliary tree; Hepatobiliary contrast agents; Gadolinium-based contrast agents; Gadobenate dimeglumine; Extracellular contrast agents
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-019-02162-5

Contrast enhanced MRI of the liver provides valuable information in the evaluation of both chronic liver disease and focal liver lesions. Currently, two classes of MRI contrast agents are available for clinical use, namely the extracellular contrast agent (ECA) and the hepatobiliary agent (HBA). The use of appropriate contrast agents for liver MRI requires knowledge of the clinical situation and question to be answered. ECAs have been used for decades since their introduction into clinical practice and provide excellent dynamic phase information that is useful in characterizing focal liver lesions. In the last decade, HBAs, particularly Gadoxetate, have been found useful for characterizing lesions with functioning hepatocytes and more importantly in evaluating the biliary tree. Gadoxetate, however, provides less satisfactory dynamic phase images compared to ECAs, particularly during the arterial phase. In this perspective article, we will discuss the various intravenous contrast agents used for liver MRI and their ideal utilization.