Assessment of liver function in primary biliary cirrhosis using Gd-EOB-DTPA-enhanced liver MRI

HPB (Oxford). 2010 Oct;12(8):567-76. doi: 10.1111/j.1477-2574.2010.00223.x.

Abstract

Objectives: Gd-EOB-DTPA (gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid) is a gadolinium-based hepatocyte-specific contrast agent for magnetic resonance imaging (MRI). The aim of this study was to determine whether the hepatic uptake and excretion of Gd-EOB-DTPA differ between patients with primary biliary cirrhosis (PBC) and healthy controls, and whether differences could be quantified.

Methods: Gd-EOB-DTPA-enhanced liver MRI was performed in 20 healthy volunteers and 12 patients with PBC. The uptake of Gd-EOB-DTPA was assessed using traditional semi-quantitative parameters (C(max) , T(max) and T(1/2) ), as well as model-free parameters derived after deconvolutional analysis (hepatic extraction fraction [HEF], input-relative blood flow [irBF] and mean transit time [MTT]). In each individual, all parameters were calculated for each liver segment and the median of the segmental values was used to define a global liver median (GLM).

Results: Although the PBC patients had relatively mild disease according to their Model for End-stage Liver Disease (MELD), Child-Pugh and Mayo risk scores, they had significantly lower HEF and shorter MTT values compared with the healthy controls. These differences significantly increased with increasing MELD and Child-Pugh scores.

Conclusions: Dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) has a potential role as an imaging-based liver function test. The high spatial resolution of MRI enables hepatic function to be assessed on segmental and sub-segmental levels.

MeSH terms

  • Adult
  • Aged
  • Blood Flow Velocity
  • Case-Control Studies
  • Contrast Media*
  • Female
  • Gadolinium DTPA*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Liver / blood supply
  • Liver / physiopathology*
  • Liver Circulation
  • Liver Cirrhosis, Biliary / diagnosis*
  • Liver Cirrhosis, Biliary / physiopathology
  • Liver Function Tests*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Perfusion Imaging*
  • Predictive Value of Tests
  • Severity of Illness Index
  • Sweden
  • Time Factors

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA