Prediction of small for size syndrome after extended hepatectomy: Tissue characterization by relaxometry, diffusion weighted magnetic resonance imaging and magnetization transfer

PLoS One. 2018 Feb 14;13(2):e0192847. doi: 10.1371/journal.pone.0192847. eCollection 2018.

Abstract

This study aimed to monitor the course of liver regeneration by multiparametric magnetic-resonance imaging (MRI) after partial liver resection characterizing Small-for-Size Syndrome (SFSS), which frequently leads to fatal post-hepatectomy liver failure (PLF). Twenty-two C57BL/6 mice underwent either conventional 70% partial hepatectomy (cPH), extended 86% partial hepatectomy (ePH) or SHAM operation. Subsequent MRI scans on days 0, 1, 2, 3, 5 and 7 in a 4.7T MR Scanner quantified longitudinal and transverse relaxation times, apparent diffusion coefficient (ADC) and the magnetization-transfer ratio (MTR) of the regenerating liver parenchyma. Histological examination was performed by hematoxylin-eosin staining. After hepatectomy, an increase of T1 time was detected being larger for ePH on day 1: 18% for cPH vs. 40% for ePH and on day 2: 24% for cPH vs. 49% for ePH. An increase in T2 time, again greater in ePH was most pronounced on day 5: 21% for cPH vs. 41% for ePH. ADC and MTR showed a decrease on day 1: 21% for ePH vs. 13% for cPH for ADC, 15% for ePH vs. 11% for cPH for MTR. Subsequently, all MR parameters converged towards initial values in surviving animals. Dying PLF animals exhibited the strongest increase of T1 relaxation time and most prominent decreases of ADC and MTR. The retrieved MRI biomarkers indicate SFSS and potentially developing PLF at an early stage, likely reflecting cellular hypertrophy with extended water content and concomitantly diluted cellular components as features of liver regeneration, appearing more intense in ePH as compared to cPH.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Enlargement
  • Diffusion Magnetic Resonance Imaging / methods*
  • Disease Models, Animal
  • Hepatectomy / adverse effects*
  • Hepatectomy / methods
  • Humans
  • Lipid Metabolism
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver / physiopathology
  • Liver Failure / diagnostic imaging*
  • Liver Failure / etiology*
  • Liver Failure / pathology
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Liver Regeneration*
  • Mice
  • Mice, Inbred C57BL
  • Organ Size
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / etiology*
  • Postoperative Complications / pathology

Grants and funding

This work was supported by the Clinical Research Priority Program - Molecular Imaging Network Zurich (CRPP - MINZ) received by AB and ML. ML received support by a professorship grant from the Swiss National Science Foundation (PP00P3_152990). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.