Gadoxetic acid-enhanced MRI of transient hepatic enhancement differences: Another cause of hypointense observation on hepatobiliary phase

Eur J Radiol. 2018 Oct:107:39-45. doi: 10.1016/j.ejrad.2018.08.013. Epub 2018 Aug 15.

Abstract

Purpose: To retrospectively determine the frequency, natural history and factors associated with the presence of transient hepatic enhancement difference showing hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced MRI.

Materials and methods: Gadoxetic acid-enhanced MRI of 125 patients (91 men; 34 women) with transient hepatic enhancement difference were retrospectively reviewed. Three readers qualitatively and quantitatively evaluated MR imaging features and evolution at follow up. The Chi-square test, Fisher's exact test and Kruskall-Wallis rank test were used for statistical analysis.

Results: Transient hepatic enhancement difference were hypointense on hepatobiliary phase images in 20 of 125 cases (16%). At univariate analysis there was association with wedge-shape morphology (p < 0.001), size ≥21 mm (p < 0.001), hyperintensity on T2-weighted imaging (p < 0.001), restricted diffusion (p < 0.001) and previous treatment (p < 0.005). At multivariate analysis, the following factors were associated: previous treatment (p < 0.05), hyperintensity on T2-weighted imaging (p < 0.001) and size ≥21 mm (p < 0.001). Of 12 patients with hypointense transient hepatic enhancement difference on hepatobiliary phase images who had follow-up MRI, nine showed reduction in size.

Conclusion: Transient hepatic enhancement difference observations showing hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced MRI are not infrequent and may shrink at follow-up. They are more likely associated with size ≥21 mm, hyperintensity on T2-weighted images and previous treatment of adjacent tumor.

Keywords: Abdomen/GI; Adults; Gadoxetic acid; Hemodynamics/flow dynamics; Liver; MR-imaging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media / pharmacokinetics*
  • Female
  • Gadolinium DTPA / pharmacokinetics*
  • Hepatocytes
  • Humans
  • Image Enhancement / methods*
  • Image Processing, Computer-Assisted / methods
  • Liver / blood supply
  • Liver / diagnostic imaging*
  • Liver Diseases / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA