Journal of Gastroenterology

, Volume 48, Issue 10, pp 1180–1187

Clinical factors predictive of insufficient liver enhancement on the hepatocyte-phase of Gd-EOB-DTPA-enhanced magnetic resonance imaging in patients with liver cirrhosis

  • Hee Yeon Kim
  • Jong Young Choi
  • Chung-Hwa Park
  • Myeong Jun Song
  • Do Seon Song
  • Chang Wook Kim
  • Si Hyun Bae
  • Seung Kew Yoon
  • Young Joon Lee
  • Sung Eun Rha
Original Article—Liver, Pancreas, and Biliary Tract

DOI: 10.1007/s00535-012-0740-7

Cite this article as:
Kim, H.Y., Choi, J.Y., Park, C. et al. J Gastroenterol (2013) 48: 1180. doi:10.1007/s00535-012-0740-7

Abstract

Background

Estimating liver parenchymal enhancement prior to gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging is crucial to accurate detection and characterization of focal hepatic lesions. We aimed to clarify the factors predictive of liver enhancement in a relatively large sample of patients.

Methods

Gd-EOB-DTPA-enhanced MR images of 328 patients with liver cirrhosis (Child–Pugh class A in 223 patients, class B in 71 patients, and class C in 34 patients) were analyzed retrospectively. The liver parenchymal signal intensity (SI) was measured in pre-contrast T1-weighted images and hepatocyte phase images. The relative enhancement (RE) was calculated: (hepatocyte phase SI–pre-contrast SI)/pre-contrast SI. We analyzed the correlation between hepatic function parameters and RE.

Results

RE of patients with Child–Pugh A cirrhosis was significantly higher than that of patients with Child–Pugh B or C cirrhosis (both P < 0.001). Among various clinical factors, platelet count, prothrombin activity, albumin, sodium, total bilirubin, aspartate aminotransferase, Model for End-stage Liver Disease (MELD) score, MELD-Na score, Child–Pugh score, and the presence of ascites were significantly correlated with RE. A multiple stepwise regression analysis revealed that MELD-Na, albumin, and the presence of ascites were the only factors that predicted liver parenchymal enhancement on hepatocyte-phase images.

Conclusion

The degree of liver parenchymal enhancement after Gd-EOB-DTPA administration was correlated with liver function parameters. Gd-EOB-DTPA-enhanced MR images require careful interpretation, particularly in patients with cirrhosis and clinical factors such as high MELD-Na score, hypoalbuminemia, or ascites.

Keywords

Gd-EOB-DTPALiver cirrhosisLiver functionMagnetic resonance imaging

Abbreviations

Gd-EOB-DTPA

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

MR

Magnetic resonance

HCC

Hepatocellular carcinoma

SI

Signal intensity

ROI

Region of interest

RE

Relative enhancement ratio

AST

Aspartate aminotransferase

ALT

Alanine aminotransferase

MELD

Model for end stage liver disease

MELDNa

Model for end stage liver disease-sodium

ICG

Indocyanine green

Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hee Yeon Kim
    • 1
  • Jong Young Choi
    • 1
  • Chung-Hwa Park
    • 1
  • Myeong Jun Song
    • 1
  • Do Seon Song
    • 1
  • Chang Wook Kim
    • 1
  • Si Hyun Bae
    • 1
  • Seung Kew Yoon
    • 1
  • Young Joon Lee
    • 2
  • Sung Eun Rha
    • 2
  1. 1.Division of Hepatology, Department of Internal Medicine, College of MedicineThe Catholic University of KoreaSeoulKorea
  2. 2.Department of Radiology, College of MedicineThe Catholic University of KoreaSeoulKorea