Noninvasive assessment of clinically significant portal hypertension using ΔT1 of the liver and spleen and ECV of the spleen on routine Gd-EOB-DTPA liver MRI

Damiano Catucci; Verena Carola Obmann; Annalisa Berzigotti; Christoph Gräni; Dominik Paul Guensch; Kady Fischer; Lukas Ebner; Johannes Thomas Heverhagen; Andreas Christe; Adrian Thomas Huber

doi:10.1016/j.ejrad.2021.109958

Noninvasive assessment of clinically significant portal hypertension using ΔT1 of the liver and spleen and ECV of the spleen on routine Gd-EOB-DTPA liver MRI

Eur J Radiol. 2021 Nov:144:109958. doi: 10.1016/j.ejrad.2021.109958. Epub 2021 Sep 20.

Affiliations

¹ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: damiano.catucci@extern.insel.ch.
² Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: verena.obmann@insel.ch.
³ Hepatology, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: annalisa.berzigotti@insel.ch.
⁴ Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: christoph.graeni@insel.ch.
⁵ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: dominik.guensch@insel.ch.
⁶ Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: kady.fischer@insel.ch.
⁷ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: lukas.ebner@insel.ch.
⁸ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: johannes.heverhagen@insel.ch.
⁹ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: andreas.christe@insel.ch.
¹⁰ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: adrian.huber@insel.ch.

PMID: 34571458
DOI: 10.1016/j.ejrad.2021.109958

Abstract

Purpose: To analyze the predictive value of ΔT1 of the liver and spleen as well as the extracellular volume fraction (ECV) of the spleen as noninvasive biomarkers for the determination of clinically significant portal hypertension (CSPH) on routine Gd-EOB-DTPA liver MRI.

Method: 195 consecutive patients with known or suspected chronic liver disease from 9/2018 to 7/2019 with Gd-EOB-DTPA liver MRI and abdominal T1 mapping were retrospectively included. Based on the presence of splenomegaly with thrombocytopenia, ascites and portosystemic collaterals, the patients were divided into noCSPH (n = 113), compensated CSPH (cCSPH, ≥1 finding without ascites; n = 55) and decompensated CSPH (dCSPH, ascites ± other findings; n = 27). T1 times were measured in the liver, spleen and abdominal aorta in the unenhanced and contrast-enhanced T1 maps. Native T1 times and ΔT1 of the liver and spleen as well as ECV of the spleen were compared between groups using the Kruskal-Wallis test with Dunn's post hoc test. Furthermore, cutoff values for group differentiation were calculated using ROC analysis with Youden's index.

Results: ΔT1 of the liver was significantly lower in patients with cCSPH and dCSPH (p < 0.001) compared to patients with noCSPH. In the ROC analyses for differentiation between noCSPH and CSPH (cCSPH + dCSPH), a cutoff of < 0.67 for ΔT1 of the liver (AUC = 0.79) performed better than ΔT1 (AUC = 0.69) and ECV (AUC = 0.63) of the spleen with cutoffs of > 0.29 and > 41.9, respectively.

Conclusion: ΔT1 of the liver and spleen in addition to ECV of the spleen allow for determination of CSPH on routine Gd-EOB-DTPA liver MRI.

Keywords: Liver diseases; Magnetic resonance imaging; Portal hypertension; Splenomegaly; T1 mapping; Venous congestion.

MeSH terms

Contrast Media
Gadolinium DTPA
Humans
Hypertension, Portal* / diagnostic imaging
Liver / diagnostic imaging
Magnetic Resonance Imaging
Retrospective Studies
Spleen* / diagnostic imaging

Substances

Contrast Media
gadolinium ethoxybenzyl DTPA
Gadolinium DTPA