3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function.

Abstract

PURPOSE:

To assess the diagnostic value of a 3D dual-flip-angle (DFA) T1 mapping technique with whole liver coverage before and after gadoxetic acid injection for assessment of cirrhosis and liver function, compared to blood tests (APRI: aspartate aminotransferase-to-platelet ratio index).

MATERIALS AND METHODS:

A total of 133 patients who underwent gadoxetic acid-enhanced liver MRI including a 3D FLASH DFA-T1 mapping sequence before and 20min post-contrast (hepatobiliary phase, HBP) were included in this retrospective IRB approved study. T1 values (msec) were measured on pre-contrast and during HBP in liver parenchyma, ΔT1 (%) was calculated as [(T1 pre-T1 post)/T1 pre]×100. T1 and ΔT1 values were compared between cirrhotic and non-cirrhotic patients and between patients stratified using Child-Pugh and Model for End-Stage Liver Disease (MELD) scores using Mann-Whitney U test. Diagnostic performance of T1 mapping parameters vs. APRI for diagnosing cirrhosis and for assessing degree of liver dysfunction was evaluated using ROC analysis.

RESULTS:

Fifty non-cirrhotic and 83 cirrhotic patients [Child-Pugh A (n=41), B (n=31) and C (n=11)] were included. There was no significant difference in pre-contrast T1 values between cirrhotic and non-cirrhotic patients. T1-HBP and ΔT1 values were significantly different in patients with cirrhosis (p<0.0001) and higher MELD scores (>17) (p=0.003). ΔT1 showed significant strong correlations with Child-Pugh and MELD scores (r=-0.7, p<0.0001; r=-0.56, p<0.001 respectively). Similar AUCs (p=0.9) for detection of liver cirrhosis were observed for T1 HBP (0.83), ΔT1 (0.86) and APRI (0.85); however APRI showed limited sensitivity (≤55%) in comparison with ΔT1 (74.7%) and T1 HBP (80.7%).

CONCLUSION:

3D DFA-T1 mapping sequence used before and after gadoxetic acid injection is useful for the diagnosis of cirrhosis and for the assessment of liver function.

• Authors: Cecilia Besa, Octavia Bane, Guido Jajamovich, Joseph Marchione, Bachir Taouli
• Journal: Magnetic resonance imaging (Magn Reson Imaging) Vol. 33 Issue 9 Pg. 1075-1082 (Nov 2015) ISSN: 1873-5894 [Electronic] Netherlands
• PMID: 26119422 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Area Under Curve
• Contrast Media
• Female
• Gadolinium DTPA
• Humans
• Imaging, Three-Dimensional (methods)
• Liver (physiopathology)
• Liver Cirrhosis (pathology)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Retrospective Studies
• Sensitivity and Specificity