Estimating liver function in a large cirrhotic cohort: Signal intensity of gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI.


Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
10 2019
Historique:
received: 21 08 2018
revised: 30 03 2019
accepted: 05 04 2019
pubmed: 4 6 2019
medline: 1 5 2020
entrez: 3 6 2019
Statut: ppublish

Résumé

To assess whether gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI study is useful to estimate liver function in comparison to the presence or absence of cirrhosis, Child Pugh (CP), Model for End-stage Liver Disease (MELD), ALBI scores and biochemical test. We retrospectively reviewed all consecutive Gd-EOB-DTPA-enhanced-MRI studies performed between 2010 and 2016 in patients with focal liver lesions undergoing clinical evaluation. Patients were divided in study and control group according to the presence of cirrhosis, and then classified by CP, MELD and ALBI. Signal intensity was calculated through the liver-to-muscle ratio in portal- (SI-POR) and hepatobiliary-phase(SI-HEP). Three-hundred-three Gd-EOB-DTPA liver-enhanced-MRI studies were included. One-hundred-ninety-one patients (63%) were cirrhotic. SI-HEP was significantly lower in cirrhotic group (0.55 ± 0.29 vs 0.66 ± 0.40, p = 0.004).The SI-HEP progressively decreased from CP-A to CP-C (0.59 ± 0.28 to 0.25 ± 0.19, p < 0.0001) and a significant difference was found between MELD ≤ 9 and MELD > 9 groups (0.61 ± 0.31 vs 0.49 ± 0.28, p = 0.007). No differences between ALBI grades were evident. Among biochemical parameters a moderate correlation was found among SI-HEP and total bilirubin, AST and albumin. SI-HEP after Gd-EOB-DTPA-enhanced-MRI effectively stratified patients with different Child Pugh grades and MELD scores. This technique could hence be useful as a novel radiological marker to estimate the underlying liver function.

Sections du résumé

BACKGROUND
To assess whether gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI study is useful to estimate liver function in comparison to the presence or absence of cirrhosis, Child Pugh (CP), Model for End-stage Liver Disease (MELD), ALBI scores and biochemical test.
METHODS
We retrospectively reviewed all consecutive Gd-EOB-DTPA-enhanced-MRI studies performed between 2010 and 2016 in patients with focal liver lesions undergoing clinical evaluation. Patients were divided in study and control group according to the presence of cirrhosis, and then classified by CP, MELD and ALBI. Signal intensity was calculated through the liver-to-muscle ratio in portal- (SI-POR) and hepatobiliary-phase(SI-HEP).
RESULTS
Three-hundred-three Gd-EOB-DTPA liver-enhanced-MRI studies were included. One-hundred-ninety-one patients (63%) were cirrhotic. SI-HEP was significantly lower in cirrhotic group (0.55 ± 0.29 vs 0.66 ± 0.40, p = 0.004).The SI-HEP progressively decreased from CP-A to CP-C (0.59 ± 0.28 to 0.25 ± 0.19, p < 0.0001) and a significant difference was found between MELD ≤ 9 and MELD > 9 groups (0.61 ± 0.31 vs 0.49 ± 0.28, p = 0.007). No differences between ALBI grades were evident. Among biochemical parameters a moderate correlation was found among SI-HEP and total bilirubin, AST and albumin.
CONCLUSION
SI-HEP after Gd-EOB-DTPA-enhanced-MRI effectively stratified patients with different Child Pugh grades and MELD scores. This technique could hence be useful as a novel radiological marker to estimate the underlying liver function.

Identifiants

pubmed: 31153787
pii: S1590-8658(19)30548-1
doi: 10.1016/j.dld.2019.04.009
pii:
doi:

Substances chimiques

Contrast Media 0
gadolinium ethoxybenzyl DTPA 0
Gadolinium DTPA K2I13DR72L
Bilirubin RFM9X3LJ49

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1438-1445

Informations de copyright

Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Auteurs

Davide Ippolito (D)

Department of Radiology, San Gerardo Hospital, Monza, Italy.

Simone Famularo (S)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Surgery, San Gerardo Hospital, Monza, Italy. Electronic address: simone.famularo@gmail.com.

Alessandro Giani (A)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Surgery, San Gerardo Hospital, Monza, Italy.

Eleonora Benedetta Orsini (EB)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Radiology, San Gerardo Hospital, Monza, Italy.

Anna Pecorelli (A)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Radiology, San Gerardo Hospital, Monza, Italy.

Enrico Pinotti (E)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Surgery, San Gerardo Hospital, Monza, Italy.

Davide Gandola (D)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.

Fabrizio Romano (F)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Surgery, San Gerardo Hospital, Monza, Italy.

Sandro Sironi (S)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Diagnostic Radiology, Papa Giovanni XXIII Hospital, Bergamo, Italy.

Davide Paolo Bernasconi (DP)

Center of Biostatistic for Clinical Epidemiology, University of Milan-Bicocca, Monza, Italy.

Luca Gianotti (L)

School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy; Department of Surgery, San Gerardo Hospital, Monza, Italy.

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Classifications MeSH