MR liver imaging with Gd-EOB-DTPA: a delay time of 10 minutes is sufficient for lesion characterisation

Abstract

ObjectivesTo assess whether, in patients with normal liver function, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient for lesion characterisation.MethodsIn 42 consecutive patients with suspected focal liver lesions, dynamic MRI was performed after intravenous Gd-EOB-DTPA, followed by hepatobiliary phases at 5, 10 and 20 min. The following items were assessed at each hepatobiliary phase: parenchymal enhancement, contrast agent excretion in bile ducts, lesion enhancement characteristics (hypo-, iso-, or hyperintensity, rim enhancement, central non-enhancement), and contrast- and signal-to-noise ratios, separately for hypo- and hyperintense lesions.ResultsFollowing enhancement, parenchymal signal intensity increased significantly up to 10 min (86.3%, P < 0.001), and subsequently stabilised (86.5% after 20 min, P = 0.223). Biliary contrast agent excretion was first observed in 2, 32 and 5 patients after 5, 10 and 20 min respectively. Hepatobiliary lesion enhancement characteristics observed after 5 min persisted during later hepatobiliary phases. CNR and SNR ratios increased significantly (P < 0.05) up to 10 min after enhancement without further increase at 20 min, in hypo- and hyperintense lesions.ConclusionsIf lesion characterisation is the primary reason for performing MRI, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient in patients with normal liver function.Key Points• Magnetic resonance imaging is now a first line of investigation of the liver.• Optimal CNR and SNR are achieved 10 min after Gd-EOB-DTPA injection.• Typical enhancement characteristics are observed early and do not change.• Ten-minute hepatobiliary delay is sufficient for characterisation of focal liver lesions.

Effects of Gadoxetate Disodium (Eovist®) Contrast on Magnetic Resonance Imaging Characteristics of the Liver in Clinically Healthy Dogs

“…Similar to the human literature, the dogs in our study exhibited a steady increase of contrast enhancement between 1 and 10 min after contrast administration with a steady plateau observed after the peak . Contrast enhancement of the liver in humans using gadoxetate disodium peaks around 10–20 min with enhancement observed up to 2 h after contrast administration .…”

Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography

“…Therefore, Strasberg et al [25] made the Bismuth classification much more comprehensive by including other types of laparoscopic extrahepatic bile duct injury (Table 6). Type A, a common form of bile duct injury, is seen after laparoscopic cholecystectomy and involves leakage from the cystic duct or the bile ducts of Luschka [24, 28, 32, 33]. Bile leaks usually manifest within the first postoperative week, whereas strictures without a bile leak tend to manifest several months to years after surgery [26].…”

“…As we had excluded the patients with increased total serum bilirubin over 17 mg/dl, we successfully evaluated the biliary tree on CE-MRC in our study. We should point out that the excretion of Gd-EOB-DTPA into the biliary tree interferes with successful visualisation of biliary fluid at conventional T2w-MRC, because at a higher concentration of the contrast material the signal intensity of bile appears darker on T2w images, owing to the T2-shortening effect of concentrated contrast material within the bile ducts [24]. Therefore, we acquired conventional T2w-MRC first in order to avoid the darkening effect of Gd-EOB-DTPA in the biliary tree.…”

Chinese consensus on the clinical application of hepatobiliary magnetic resonance imaging contrast agent: Gadoxetic acid disodium

“…However, in patients with a normal hepatic function, the HBP delay time may be reduced to 10 min. 42,43 In cases of chronic liver disease, the enhancement of hepatic parenchyma and the excretion time of the biliary system are affected by the severity of hepatic dysfunction 44 and therefore, the HBP delay time should be prolonged to 30 min. 45 b) Selection of flip angles: Generally, the flip angle for conventional MRI multiphase dynamic enhancement scan is 9 to 15 , but for Gd-EOB-DTPA-enhanced MRI increasing the flip angle can improve the contrast ratio between lesions and normal hepatic parenchyma on the HBP, leading to facilitating visualization of minor lesions 46,47 as well as the biliary system.…”