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

Verloh, Niklas; Haimerl, Michael; Rennert, Janine; Müller-Wille, René; Niessen, Christoph; Kirchner, Gabriele I.; Scherer, Marcus N.; Schreyer, A. G.; Stroszczynski, Christian; Fellner, Claudia; Wiggermann, Philipp

doi:10.1016/j.ejrad.2013.05.033

Cited by 54 publications

(52 citation statements)

References 31 publications

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“…The signal intensity (SI) changes of liver after injection of gadoxetate have been investigated to determine correlation with grade of fibrosis [4,8,9], hepatic function [10][11][12] and outcome after liver-directed intervention [13][14][15]. However, such SI changes are dependent on extraneous factors including the injected dose, relative renal function, and the presence of hepatic steatosis [16][17][18].…”

mentioning

confidence: 99%

Value of gadoxetate biliary transit time in determining hepatocyte function

Yang

et al. 2014

Abdom Imaging

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confidence: 99%

Value of gadoxetate biliary transit time in determining hepatocyte function

Yang

et al. 2014

Abdom Imaging

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“…In general, the DHBP with Gd-EOB-DTPA is acquired about 20 min after contrast administration, because at this time normal hepatocytes reach maximum signal intensity [25]. However, the time of contrast uptake may differ between individuals because the hepatic elimination pathway is related to hepatocyte function [26]. Studies indicate that enhancement of liver parenchyma is best at 20 min after administration of Gd-EOB-DTPA followed by a signal intensity plateau for at least 2 h [27,28].…”

Section: Discussionmentioning

confidence: 99%

Does gadoxetate disodium affect MRE measurements in the delayed hepatobiliary phase?

et al. 2018

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Objectives To assess if the administration of gadoxetate disodium (Gd-EOB-DTPA) significantly affects hepatic magnetic resonance elastography (MRE) measurements in the delayed hepatobiliary phase (DHBP). Methods A total of 47 patients (15 females, 32 males; age range 23-78 years, mean 54.28 years) were assigned to standard hepatic magnetic resonance imaging (MRI) with application of Gd-EOB-DTPA and hepatic MRE. MRE was performed before injection of Gd-EOB-DTPA and after 40-50 min in the DHBP. Liver stiffness values were obtained before and after contrast media application and differences between pre-and post-Gd-EOB-DTPA values were evaluated using a Bland-Altman plot and the Mann-Whitney-Wilcoxon test. In addition, the data were compared with regard to the resulting fibrosis classification. Results Mean hepatic stiffness for pre-Gd-EOB-DTPA measurements was 4.01 kPa and post-Gd-EOB-DTPA measurements yielded 3.95 kPa. We found a highly significant individual correlation between pre-and post-Gd-EOB-DTPA stiffness values (Pearson correlation coefficient of r = 0.95 (p < 0.001) with no significant difference between the two measurements (p =0.49)). Bland-Altman plot did not show a systematic effect for the difference between pre-and post-stiffness measurements (mean difference: 0.06 kPa, SD 0.81). Regarding the classification of fibrosis stages, the overall agreement was 87.23% and the intraclass correlation coefficient was 96.4%, indicating excellent agreement. Conclusions Administration of Gd-EOB-DTPA does not significantly influence MRE stiffness measurements of the liver in the DHBP. Therefore, MRE can be performed in the DHBP. Key Points • MRE of the liver can reliably be performed in the delayed hepatobiliary phase.• Gd-EOB-DTPA does not significantly influence MRE stiffness measurements of the liver.• MRE performed in the delayed hepatobiliary-phase is reasonable in patients with reduced liver function.

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“…The MELD score is reflective of the severity of cirrhosis, and severe cirrhosis is associated with worse parenchymal enhancement on HBP. 23,24 Additionally, a higher MELD score is a surrogate for worsening liver function; therefore, an increasing MELD score may indicate declining hepatocyte expression of proteins, including the organic anion transporter polypeptide 1 (OATP1) required for Gd-EOB-DTPA uptake by the liver, a hypothesis that is supported by a number of animal studies. 25,26 Hence, once an individual has developed a certain degree of liver dysfunction, the rate of Gd-EOB-DTPA uptake would likely slow to the point where delaying imaging for an additional 10 minutes would not result in perceivable improvement of hepatic enhancement.…”

Section: Discussionmentioning

confidence: 99%