Dynamic-contrast-enhanced magnetic resonance imaging of cirrhotic liver parenchyma: A comparison between gadolinium-diethylenetriamine pentaacetic acid and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

Chun-Yi Lin; Wei-Chou Chang; Chen-Te Chou; Ran-Chou Chen

doi:10.1016/j.jcma.2015.07.005

Dynamic-contrast-enhanced magnetic resonance imaging of cirrhotic liver parenchyma: A comparison between gadolinium-diethylenetriamine pentaacetic acid and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid

J Chin Med Assoc. 2015 Nov;78(11):666-72. doi: 10.1016/j.jcma.2015.07.005. Epub 2015 Sep 2.

Authors

Chun-Yi Lin¹, Wei-Chou Chang², Chen-Te Chou³, Ran-Chou Chen⁴

Affiliations

¹ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University Hospital, Yilan, Taiwan, ROC.
² Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
³ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan, ROC.
⁴ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Radiology, Taipei City Hospital, Taipei, Taiwan, ROC. Electronic address: chenranchou@yahoo.com.tw.

PMID: 26341453
DOI: 10.1016/j.jcma.2015.07.005

Abstract

Background: The newly developed magnetic-resonance-imaging (MRI) hepatocyte-specific contrast agent, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), has different excretion pathways from the conventional MRI contrast agent, gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). In this study, we compare the enhancement effect of the liver and renal parenchyma between these two contrast agents for patients with liver cirrhosis.

Methods: We retrospectively included 49 consecutive patients with liver cirrhosis who underwent Gd-DTPA- and Gd-EOB-DTPA-enhanced MRIs within 3 months. We measured the signal intensity of the liver and kidney, and calculated the enhancement ratio (ER) in the arterial phase, portal venous phase, and venous phase (VP). We also calculated a delayed phase (DP) when Gd-DTPA was used, and a hepatocyte phase (HP) when Gd-EOB-DTPA was used. The ERs were compared between the two contrast agents. The effect of liver function on the ERs was also evaluated.

Results: The ER of the liver with Gd-EOB-DTPA was significantly higher than with Gd-DTPA in the VP (p = 0.01) and in the HP/DP (p = 0.01). The ER of the kidney in the DP with Gd-DTPA was significantly higher than in the HP with Gd-EOB-DTPA (p < 0.001). The ERs of the liver using Gd-EOB-DTPA for patients with normal serum bilirubin were significantly higher than those with abnormal levels (p = 0.047), but there was no significant difference using Gd-DTPA.

Conclusion: The enhancement effect of the liver parenchyma using both MRI contrast agents was not affected by the degree of liver cirrhosis or abnormal liver function. However, it was affected by the serum-bilirubin levels in the Gd-EOB-DTPA-enhanced MRIs. Furthermore, enhancement of the liver was higher when using Gd-EOB-DTPA in the VP, DP, and HP. This knowledge is helpful when performing dynamic MRIs to diagnose focal hepatic lesions in the heterogeneous liver parenchyma.

Keywords: Gd–DTPA; Gd–EOB–DTPA; liver cirrhosis; magnetic resonance imaging.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Bilirubin / blood
Contrast Media
Gadolinium DTPA
Humans
Image Enhancement
Kidney / pathology
Liver / pathology
Liver Cirrhosis / pathology*
Magnetic Resonance Imaging*
Male
Retrospective Studies

Substances

Contrast Media
gadolinium ethoxybenzyl DTPA
Gadolinium DTPA
Bilirubin