Predicting post-hepatectomy liver failure by combined volumetric, functional MR image and laboratory analysis.

Abstract

BACKGROUND & AIMS:

To assess the efficacy of functional MR image with volumetric, liver function test and indocyanine green clearance (ICG) in identifying the patients who are at risk of post-hepatectomy liver failure (PHLF).

METHODS:

We retrospectively included 115 patients undergoing gadoxetic acid-enhanced MR imaging before hepatectomy at one medical centre from January 2013 to December 2015. Contrast enhancement ratio (CER) between transitional and hepatobiliary phases (3 and 30 minutes post-contrast) was calculated. Total liver volume (TLV) and spleen volume (Sp) were measured. Post-operatively, the histological Ishak fibrosis score was collected. Potential risk factors for liver failure were analysed, and the performance was examined by receiver operating characteristic curve.

RESULTS:

Post-hepatectomy liver failure (PHLF) occurred in 16 patients (13.9%). TLV/SLV, ADC value, CERHBP/TP and total liver contrast enhancement ratio (tCER) were associated with PHLF (P < .05). Between PHLF and non-PHLF groups, remnant liver volume (RLV), RLV/SLV, Sp/RLV, remnant liver contrast enhancement ratio (rCER) and Ishak fibrosis score showed statistical difference. rCER showed superiority in diagnostic performance (AUC = 0.78) with the optimal cut-off value of 1.23.

CONCLUSIONS:

Gadoxetic acid-enhanced MR imaging with volumetric is a reliable method for evaluating functional liver volume and determining the risk of PHLF.

• Authors: Yi-Hsuan Chuang, Hsin-You Ou, Marirose Z Lazo, Chao-Long Chen, Meng-Hsiang Chen, Ching-Chun Weng, Yu-Fan Cheng
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 38 Issue 5 Pg. 868-874 (05 2018) ISSN: 1478-3231 [Electronic] United States
• PMID: 28987012 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Indocyanine Green
• Gadolinium DTPA

Topics

• Adult
• Aged
• Contrast Media
• Female
• Gadolinium DTPA
• Hepatectomy
• Humans
• Indocyanine Green
• Liver (pathology, physiopathology)
• Liver Failure (diagnostic imaging, etiology)
• Liver Function Tests
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Organ Size
• Postoperative Complications (diagnostic imaging, etiology)
• ROC Curve
• Retrospective Studies