Mi Sun Chung MD, Presenter: Nothing to Disclose

So Yeon Kim MD, Abstract Co-Author: Nothing to Disclose

Seung Soo Lee MD, Abstract Co-Author: Nothing to Disclose

Ki Jin Kim, Abstract Co-Author: Nothing to Disclose

Jae Ho Byun MD, Abstract Co-Author: Nothing to Disclose

Seong Ho Park MD, Abstract Co-Author: Nothing to Disclose

Jin Hee Kim MD, Abstract Co-Author: Nothing to Disclose

Hyoung Jung Kim, Abstract Co-Author: Nothing to Disclose

Moon-Gyu Lee MD, Abstract Co-Author: Nothing to Disclose

To determine optimal arterial-phase scan timing for Gd-EOB-DTPA enhanced liver MR in patients with cirrhosis.

Gd-EOB-DTPA enhanced liver MR studies from 339 patients [179 with cirrhosis (152 men, 27 women; mean age, 58.7 years) and 160 without cirrhosis (105 men, 55 women; mean age, 56.4 years)] were retrospectively evaluated. After the administration of 1mL Gd-EOB-DTPA, followed by 20mL of normal saline at 1mL/sec, test bolus images were acquired every second for one minute with a spoiled gradient-echo T1 transverse section through the upper abdomen. The scan time for the arterial phase (TAP) was determined by adding 5 seconds to the time to peak test bolus enhancement. Hepatic arterial-phase MR imaging (scan duration = 13-15 sec depending on the coverage) was performed using a 3D spoiled gradient echo T1 sequence with the center k-space scheme. TAP was compared between the two groups using the student t test. MR images were evaluated for the appropriate acquisition of the late arterial phase and splenic moiré pattern. The Fisher exact test was used to compare the relative prevalence of this acquisition between cirrhotic and noncirrhotic livers. Multiple logistic regression analyses were performed to test the effect of age, sex, hypertension, diabetes mellitus, heart and renal disease on the acquisition of late arterial phase.

The TAP was significantly delayed in cirrhotic livers (mean ± SD, 30.0±0.5 seconds) than it was in noncirrhotic livers (28.7± 0.5 seconds) (P=.01). Nonetheless, the late arterial phase was captured less frequently in cirrhotic livers (66.5%, 119/179) than in noncirrhotic livers (86.3%, 138/160) (P<.01). Splenic moiré pattern was also less commonly present in cirrhotic livers (77.7%, 139/179) than in noncirrhotic livers (87.5%, 140/160) (P=.02). Age, sex, hypertension, diabetes mellitus, heart and renal disease had no significant effect on the acquisition of late arterial phase.

Compared with noncirrhotic livers, cirrhotic livers require an increased diagnostic delay to achieve the appropriate late arterial-phase scan timing in Gd-EOB-DTPA enhanced liver MR imaging.

The determination of the optimal arterial-phase scan timing for Gd-EOB-DTPA enhanced MR of cirrhotic livers may require an additional diagnostic delay.

Chung, M, Kim, S, Lee, S, Kim, K, Byun, J, Park, S, Kim, J, Kim, H, Lee, M, Determination of Optimal Arterial-phase Scan Timing for Gd-EOB-DTPA Enhanced Liver MR Imaging in Patients with Cirrhosis.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043483.html