• Hee Yeon Kim, Jong Young Choi, Chung-Hwa Park, Myeong Jun Song, Do Seon Song, Chang Wook Kim, Si Hyun Bae, Seung Kew Yoon, Young Joon Lee, and Sung Eun Rha.
• Division of Hepatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul, 137-040, Korea.
• J. Gastroenterol. 2013 Oct 1; 48 (10): 1180-7.

BackgroundEstimating liver parenchymal enhancement prior to gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging is crucial to accurate detection and characterization of focal hepatic lesions. We aimed to clarify the factors predictive of liver enhancement in a relatively large sample of patients.MethodsGd-EOB-DTPA-enhanced MR images of 328 patients with liver cirrhosis (Child-Pugh class A in 223 patients, class B in 71 patients, and class C in 34 patients) were analyzed retrospectively. The liver parenchymal signal intensity (SI) was measured in pre-contrast T1-weighted images and hepatocyte phase images. The relative enhancement (RE) was calculated: (hepatocyte phase SI-pre-contrast SI)/pre-contrast SI. We analyzed the correlation between hepatic function parameters and RE.ResultsRE of patients with Child-Pugh A cirrhosis was significantly higher than that of patients with Child-Pugh B or C cirrhosis (both P < 0.001). Among various clinical factors, platelet count, prothrombin activity, albumin, sodium, total bilirubin, aspartate aminotransferase, Model for End-stage Liver Disease (MELD) score, MELD-Na score, Child-Pugh score, and the presence of ascites were significantly correlated with RE. A multiple stepwise regression analysis revealed that MELD-Na, albumin, and the presence of ascites were the only factors that predicted liver parenchymal enhancement on hepatocyte-phase images.ConclusionThe degree of liver parenchymal enhancement after Gd-EOB-DTPA administration was correlated with liver function parameters. Gd-EOB-DTPA-enhanced MR images require careful interpretation, particularly in patients with cirrhosis and clinical factors such as high MELD-Na score, hypoalbuminemia, or ascites.

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