Optimal timing and diagnostic adequacy of hepatocyte phase imaging with gadoxetate-enhanced liver MRI.

Abstract:

RATIONALE AND OBJECTIVES:To evaluate clinical and imaging features associated with adequacy of the hepatocyte phase (HP) in gadoxetate disodium-enhanced liver magnetic resonance imaging (MRI) in patients without chronic liver disease (CLD). MATERIALS AND METHODS:This was a retrospective institutional review board-approved study of 97 patients who underwent liver MRI examinations with gadoxetate disodium and had no history of CLD. Available late dynamic and HP sequences (3-20 minutes postinjection) were independently analyzed by four radiologists for perceived image adequacy and level of biliary enhancement. Signal intensity ratios (SIRs) of liver/inferior vena cava (IVC), liver/spleen, and liver/muscle were measured. The Spearman ρ and receiver operating characteristic analyses were performed correlating various factors with HP adequacy. A rule for predicting HP adequacy was also derived and tested to determine whether overall examination time could be shortened. RESULTS:A visually adequate HP was observed in 12% of subjects by 10 minutes, 80% by 15 minutes, and 93% by 20 minutes. An SIRliver/IVC > 1.8 was the imaging feature that had the strongest correlation with an adequate HP (ρ = 0.813, P < .001), and was more predictive of adequacy of the HP than the time postinjection (ρ = 0.5, P < .001). The time at which an adequate HP was first observed did not correlate with any tested demographic or laboratory values. Stopping imaging when an SIRliver/IVC > 1.8 would have successfully reduced mean postcontrast time to 15:39 ± 4:02 from 20:00 (P < .001), although maintaining HP adequacy. CONCLUSIONS:Most patients without CLD undergoing gadoxetate-enhanced liver MRI achieve adequate HP at 20 minutes. However, a shorter postcontrast stopping time can be used in most patients.

journal_name

Acad Radiol

journal_title

Academic radiology

authors

Bashir MR,Breault SR,Braun R,Do RK,Nelson RC,Reeder SB

doi

10.1016/j.acra.2014.02.005

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

726-32

issue

6

eissn

1076-6332

issn

1878-4046

pii

S1076-6332(14)00084-1

journal_volume

21

pub_type

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