Impact of liver cirrhosis on liver enhancement at Gd-EOB-DTPA enhanced MRI at 3 Tesla

• Published in: European journal of radiology Vol. 82; no. 10; pp. 1710 - 1715
• Main Authors: Verloh, N, Haimerl, M, Rennert, J, Müller-Wille, R, Nießen, C, Kirchner, G, Scherer, M.N, Schreyer, A.G, Stroszczynski, C, Fellner, C, Wiggermann, P
• Format: Journal Article
• Language: English
• Published: Ireland 01.10.2013
• Subjects: Algorithms; Contrast Media; Female; Gadolinium DTPA; Humans; Image Enhancement - methods; Liver - pathology; Liver Cirrhosis - pathology; Magnetic Resonance Imaging - methods; Male; Middle Aged; Radiology; Reproducibility of Results; Sensitivity and Specificity; Magnetic resonance imaging (MRI); Liver function; 3 Tesla; Gd-EOB-DTPA; Liver cirrhosis; 3Tesla
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2013.05.033

Abstract Purpose The purpose of this study was to assess differences in enhancement effects of liver parenchyma between normal and cirrhotic livers on dynamic, Gd-EOB-DTPA enhanced MRI at 3 T. Materials and methods 93 patients with normal ( n = 54) and cirrhotic liver ( n = 39; Child–Pugh class A, n = 18; B, n = 16; C, n = 5) underwent contrast-enhanced MRI with liver specific contrast media at 3 T. T1-weighted volume interpolated breath hold examination (VIBE) sequences with fat suppression were acquired before contrast injection, in the arterial phase (AP), in the late arterial phase (LAP), in the portal venous phase (PVP), and in the hepatobiliary phase (HBP) after 20 min. The relative enhancement (RE) of the signal intensity of the liver parenchyma was calculated for all phases. Results Mean RE was significantly different among all evaluated groups in the hepatobiliary phase and with increasing severity of liver cirrhosis, a decreasing, but still significant reduction of RE could be shown. Phase depending changes of RE for each group were observed. In case of non-cirrhotic liver or Child–Pugh Score A cirrhosis mean RE showed a significant increase between AP, LAP, PVP and HBP. For Child–Pugh B + C cirrhosis RE increased until PVP, however, there was no change in case of B cirrhosis ( p = 0.501) and significantly reduced in case of C cirrhosis ( p = 0.043) during HBP. Conclusion RE of liver parenchyma is negatively affected by increased severity of liver cirrhosis, therefore diagnostic value of HBP could be limited in case of Child Pugh B + C cirrhosis.