Quantitative assessment of hepatic function: modified look-locker inversion recovery (MOLLI) sequence for T1 mapping on Gd-EOB-DTPA-enhanced liver MR imaging
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To determine whether multislice T1 mapping of the liver using a modified look-locker inversion recovery (MOLLI) sequence on gadoxetic acid-enhanced magnetic resonance imaging (MRI) can be used as a quantitative tool to estimate liver function and predict the presence of oesophageal or gastric varices.
Phantoms filled with gadoxetic acid were scanned three times using MOLLI sequence to test repeatability. Patients with chronic liver disease or liver cirrhosis who underwent gadoxetic acid-enhanced liver MRI including MOLLI sequence at 3 T were included (n = 343). Pre- and postcontrast T1 relaxation times of the liver (T1liver), changes between pre- and postcontrast T1liver (ΔT1liver), and adjusted postcontrast T1liver (postcontrast T1liver-T1spleen/T1spleen) were compared among Child-Pugh classes. In 62 patients who underwent endoscopy, all T1 parameters and spleen sizes were correlated with varices.
Phantom study showed excellent repeatability of MOLLI sequence. As Child-Pugh scores increased, pre- and postcontrast T1liver were significantly prolonged (P < 0.001), and ΔT1liver and adjusted postcontrast T1liver decreased (P < 0.001). Adjusted postcontrast T1liver and spleen size were independently associated with varices (R 2 = 0.29, P < 0.001).
T1 mapping of the liver using MOLLI sequence on gadoxetic acid-enhanced MRI demonstrated potential in quantitatively estimating liver function, and adjusted postcontrast T1liver was significantly associated with varices.
• T1 mapping using MOLLI sequence can be achieved within a breath-hold.
• T1liver measured by MOLLI sequence provided excellent short-term repeatability.
• Precontrast and postcontrast T1liver were significantly prolonged as Child-Pugh scores increased.
• Adjusted postcontrast T1liver and spleen size were independently associated with varices.
KeywordsT1 map Gadoxetic acid Magnetic resonance imaging MOLLI Liver function estimation
Modified look-locker inversion recovery
Magnetic resonance imaging
Organic anion transporter
T1 relaxation time of the liver (ms)
T1 relaxation time of the spleen (ms)
Change in T1 relaxation time of the liver before and after Gd-EOB-DTPA administration, divided by the precontrast T1 relaxation time of the liver ([precontrast T1liver-postcontrast T1liver]/precontrast T1liver)
- Adjusted postcontrast T1liver
Modulus of the difference between postcontrast T1 relaxation time of the liver, and postcontrast T1 relaxation time of the spleen divided by the postcontrast T1 relaxation time of the spleen ([T1liver-T1spleen]/T1spleen)
We thank Chris Woo (B.A., USA) for his editorial assistance. The scientific guarantor of this publication is professor Jeong Min Lee. Authors of this manuscript declare relationships with the following companies: J.M.L., author received nonfinancial technical support from Siemens Healthcare; M.P, an employee of Siemens Healthcare. The authors state that this research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2013R1A1A2A10066037). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, case-control study, performed at one institution.
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