European Radiology

, Volume 22, Issue 4, pp 864–871 | Cite as

Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases

  • Na-Young Shin
  • Myeong-Jin Kim
  • Joon Seok Lim
  • Mi-Suk Park
  • Yong-Eun Chung
  • Jin-Young Choi
  • Ki Whang Kim
  • Young-Nyun Park



To assess whether reticular hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) is a diagnostic finding of sinusoidal obstruction syndrome (SOS) in patients with hepatic metastases who have undergone chemotherapy.


We retrospectively analysed EOB-MRI of 42 patients who had undergone chemotherapy before hepatic resection of colorectal hepatic metastases. Two radiologists, who were unaware of whether or not the patients had SOS, reviewed the hepatobiliary phase images to determine the presence of hypointense reticulation in the liver using a 5-point scale. The sensitivity, specificity and area under the receiver operating characteristics curve (Az) were calculated for each reviewer.


The sensitivity, specificity and Az for the diagnosis of SOS were 75%, 100% and 0.957 for reader 1 and 75%, 96.2% and 0.936 for reader 2, respectively. In one patient who received a false-positive diagnosis by one reader, there was sinusoidal fibrosis on histological examination, but not diagnostic for SOS. False-negative diagnosis occurred in four patients for both readers; histology of these patients showed minimal and localised sinusoidal congestion and fibrosis.


Reticular hypointensity on hepatobiliary phase images of EOB-MRI is highly specific for the diagnosis of SOS in patients with treated colorectal hepatic metastases.

Key Points

Gadoxetic acid enhanced magnetic resonance imaging (EOB-MRI) can identify the sinusoidal obstruction syndrome (SOS)

The diagnosis can be achieved with high specificity and good interobserver agreement.

SOS typically demonstrates diffuse hypointensity on hepatobiliary phase images on EOB-MRI.

EOB-MRI may be falsely negative in patients with minimal degree of SOS.


Hepatic veno-occlusive disease Magnetic resonance imaging Colorectal neoplasms Liver neoplasms Antineoplastic agents 


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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Na-Young Shin
    • 1
  • Myeong-Jin Kim
    • 1
  • Joon Seok Lim
    • 1
  • Mi-Suk Park
    • 1
  • Yong-Eun Chung
    • 1
  • Jin-Young Choi
    • 1
  • Ki Whang Kim
    • 1
  • Young-Nyun Park
    • 2
  1. 1.Department of RadiologyYonsei University Severance HospitalSeoulSouth Korea
  2. 2.Department of PathologyYonsei University Severance HospitalSeoulSouth Korea

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