Assessing liver function: diagnostic efficacy of parenchymal enhancement and liver volume ratio of Gd-EOB-DTPA-enhanced MRI study during interstitial and hepatobiliary ... View Full Text


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Article Info

DATE

2018-11-08

AUTHORS

Davide Ippolito, Anna Pecorelli, Simone Famularo, Davide Bernasconi, Eleonora Benedetta Orsini, Alessandro Giani, Fabrizio Romano, Cammillo Talei Franzesi, Sandro Sironi

ABSTRACT

AimTo assess the efficacy of signal intensity in interstitial and hepatobiliary phase normalized for liver volume, on gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) study, for the evaluation of liver function through the comparison with Child–Pugh (CP), model for end-stage liver disease (MELD), and biochemical tests.MethodsAll dynamic Gd-EOB-DTPA MRI studies performed in patients with suspected liver lesions were retrospectively reviewed. The rate of liver-to-muscle ratio on T1 sequence 70 s (interstitial phase) and 20 min (hepatobiliary phase) after injection of Gd-EOB-DTPA was calculated for each MRI study and then normalized for liver volume (irINTnorm and irHEPnorm). Pearson correlation coefficient was computed to assess the correlation among these values and CP and MELD scores, and biochemical tests.ResultsA total of 303 MRI studies, performed on 221 patients, were included. Mean age was 63.8 years ± 12.9 with a majority of male patients (186; 61.4%). A total of 186 out of 303 (61.4%) were cirrhotic patients. The irHEPnorm was significantly lower in cirrhotic than non-cirrhotic patients (0.0004 ± 0.0002 to 0.0005 ± 0.0003, p = 0.010). This value had a moderate, significant correlation with Child–Pugh and MELD scores (R = − 0.292, p < 0.0001 and R = − 0.192, p = 0.010, respectively). In particular, irHEPnorm progressively decreased from Child–Pugh A to C (0.0004–0.0002, p < 0.0001) and from MELD ≤ 10 to 19–24 (0.0004–0.0003, p = 0.018). Among biochemical parameters, total bilirubin, GOT, and albumin had the strongest correlation with irHEPnorm (R = − 0.258, − 0.291, and 0.262, p < 0.0001, respectively). No correlations were found between irINTnorm and CP and MELD scores.ConclusionirHEPnorm value derived from Gd-EOB-DTPA-enhanced MRI is a reliable, non-invasive, useful tool to quantify liver function and to assess the degree of cirrhosis, offering a strict relationship with clinical scores and biochemical parameters. This could help surgeons in clinical decision-making, allowing them to choose the more suitable surgical approach for cirrhotic patients. More... »

PAGES

1340-1349

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00261-018-1812-9

DOI

http://dx.doi.org/10.1007/s00261-018-1812-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1109785393

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30411177


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24 schema:description AimTo assess the efficacy of signal intensity in interstitial and hepatobiliary phase normalized for liver volume, on gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) study, for the evaluation of liver function through the comparison with Child–Pugh (CP), model for end-stage liver disease (MELD), and biochemical tests.MethodsAll dynamic Gd-EOB-DTPA MRI studies performed in patients with suspected liver lesions were retrospectively reviewed. The rate of liver-to-muscle ratio on T1 sequence 70 s (interstitial phase) and 20 min (hepatobiliary phase) after injection of Gd-EOB-DTPA was calculated for each MRI study and then normalized for liver volume (irINTnorm and irHEPnorm). Pearson correlation coefficient was computed to assess the correlation among these values and CP and MELD scores, and biochemical tests.ResultsA total of 303 MRI studies, performed on 221 patients, were included. Mean age was 63.8 years ± 12.9 with a majority of male patients (186; 61.4%). A total of 186 out of 303 (61.4%) were cirrhotic patients. The irHEPnorm was significantly lower in cirrhotic than non-cirrhotic patients (0.0004 ± 0.0002 to 0.0005 ± 0.0003, p = 0.010). This value had a moderate, significant correlation with Child–Pugh and MELD scores (R = − 0.292, p < 0.0001 and R = − 0.192, p = 0.010, respectively). In particular, irHEPnorm progressively decreased from Child–Pugh A to C (0.0004–0.0002, p < 0.0001) and from MELD ≤ 10 to 19–24 (0.0004–0.0003, p = 0.018). Among biochemical parameters, total bilirubin, GOT, and albumin had the strongest correlation with irHEPnorm (R = − 0.258, − 0.291, and 0.262, p < 0.0001, respectively). No correlations were found between irINTnorm and CP and MELD scores.ConclusionirHEPnorm value derived from Gd-EOB-DTPA-enhanced MRI is a reliable, non-invasive, useful tool to quantify liver function and to assess the degree of cirrhosis, offering a strict relationship with clinical scores and biochemical parameters. This could help surgeons in clinical decision-making, allowing them to choose the more suitable surgical approach for cirrhotic patients.
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31 schema:keywords AimTo
32 Child-Pugh
33 ConclusionirHEPnorm value
34 DTPA
35 DTPA MRI studies
36 DTPA-enhanced MRI
37 DTPA-enhanced MRI study
38 GOT
39 Gd-EOB
40 MELD
41 MELD score
42 MRI
43 MRI studies
44 MethodsAll dynamic Gd-EOB
45 Pearson correlation coefficient
46 ResultsA total
47 T1 sequence 70 s
48 acid
49 age
50 albumin
51 approach
52 bilirubin
53 biochemical parameters
54 biochemical tests
55 cirrhosis
56 cirrhotic patients
57 clinical scores
58 coefficient
59 comparison
60 correlation
61 correlation coefficient
62 degree
63 degree of cirrhosis
64 diagnostic efficacy
65 diethylenetriaminepentaacetic acid
66 disease
67 dynamic Gd-EOB
68 efficacy
69 end-stage liver disease
70 enhancement
71 evaluation
72 function
73 hepatobiliary phase
74 imaging studies
75 injection
76 intensity
77 irHEPnorm
78 irINTnorm
79 lesions
80 liver
81 liver disease
82 liver function
83 liver lesions
84 liver volume
85 liver volume ratio
86 magnetic resonance imaging study
87 majority
88 male patients
89 mean age
90 min
91 model
92 muscle ratio
93 non-cirrhotic patients
94 parameters
95 parenchymal enhancement
96 patients
97 phase
98 rate
99 rate of liver
100 ratio
101 relationship
102 resonance imaging study
103 scores
104 sequence 70 s
105 signal intensity
106 significant correlation
107 strict relationship
108 strong correlation
109 study
110 suitable surgical approach
111 surgeons
112 surgical approach
113 test
114 tool
115 total
116 total bilirubin
117 useful tool
118 values
119 volume
120 volume ratio
121 years
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