| Purpose: To investigate the relationship between the liver signal intensity in thehepatobiliary phase in gadolinium ethoxybenzyl diethylenetriamine pentaaceticacid(gadoxetic acid, Gd-EOB-DTPA)-enhanced magnetic resonance imaging and liverfunction; to discuss the value of contrast-enhanced magnetic resonancecholangiography(CE-MRC) using Gd-EOB-DTPA in patients with liver cirrhosis andthe relationship between liver function and CE-MRC.Methods: This study included55patients with cirrosis due to hepatitis B and18adultnormal as control group, the subjects received laboratory tests of liver function.Thecollected clinical datum included serum total bilirubin level, albumin level,prothrombim time and glutamic pyruvic transaminase, and whether the subjects hadascites and encephalopathy or not in the period of three days before MR examination.Then performed the Child-Pugh score. The MR examination adopted the magneticresonance apparatus of Signa HDxt3.0T which was manufactured by GE company.The subjects must be on an empty stomach for more than6hours before theexamination. The contrast medium used in enhancement scanning was Gd-EOB-DTPA,its dose was0.025mmol/Kg,its injection speed was1.0ml/S, and then injectedphysiological saline of the same dose.And to perform MR imaging and CE-MRCbefore injection and at5,10,15,20and25minutes after bolus administration ofGd-EOB-DTPA, the signal intensities of liver and spleen at each time point weremeasured,.The differences of the absolute value of liver,DSI(the differences of liversignal intensity between the hepatobiliary phase and plain scan), liver-to-spleen contrast ratio were analysed and the images quality of CE-MRC at5,15,20and25minutes in hepatobiliary phase were evaluated.The relationships between the hepaticsignal intensity, the signal intensity of common bile ducts and total bilirubinlevel,albumin level, and prothrombin time were also evaluated. The differencesbetween CE-MRC and MRCP were compared.Results: According to the Child-Pugh score,there were35patients in Child-Pugh Agroup,18in B group and2in C group. The signal intensity, DSI, and liver-to-spleencontrast ratio showed significant differences among the control group, Child-Pugh Agroup and Child-Pugh B group at each time-point. There were no differences of theliver signal intensity at15,20and25minutes in55patients（F=0.121,P=0.886）. Liversignal intensity in hepatobiliary phase positively correlated with and serum albuminand negtively correlated with the total bilirubin and prothrombin time. CE-MRCallowed the visualization of most parts of biliary duct at15minutes afteradministration of Gd-EOB-DTPA in normal adults. The visualization of biliary ductswere delayed in patients with liver cirrohsis, especially in cases with Child-Pugh B andC. There were no differences of signal intensity of common bile ducts at25-minutesdelayed between the normal adults and patients with child-Pugh A（P=0.570）, whilethere were differences between normal adults and Child-Pugh B（P=0.002）, betweenChild-Pugh A and Child-Pugh B（P=0.000）. In patients with liver cirrhosis,thecorrelation coefficient between signal intensity of common bile ducts and prothrombintime was﹣0.57, CE-MRC and MRCP showed79%,32%of the cystc ductsrespectively(X2=23.891,P=0.000) and had the similar ability for displaying the secondorder division ducts, bilateral hepatic ducts and common bile ducts（P＞0.05）.Conclusion: The degree of liver enhancement in hepatobiliary phase may be used toestimated liver function and correlate with the serum albumin, totalbilirubin,prothrombin time. The delay time of15minutes was suitable for liver functional assessment. It was suitable that CE-MRC were performed at25minutesafter contrast administration in patients with liver cirrhosis. The liver function affectedthe time of visualization and signal intensity of bile, CE-MRC had the advantage fordetecting the cystic ducts than MRCP. CE-MRC combined with MRCP allowedevaluation for structure and function of biliary system effectively. |
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