Jan Hinrichs MD, Abstract Co-Author: Nothing to Disclose

Henrike Lenzen, Abstract Co-Author: Nothing to Disclose

Frank K. Wacker MD, Abstract Co-Author: Research Grant, Siemens AG Research Grant, Pro Medicus Limited

Kristina Imeen Ringe MD, Presenter: Nothing to Disclose

To assess the value of gadoxetate disodium enhanced hepatic MRI in patients with PSC for evaluation of liver function and to determine a possible correlation with severity of disease.

46 patients (31 males, 15 females; mean age 44 years) with confirmed diagnosis of PSC who underwent gadoxetate disodium enhanced hepatic MRI on a 1.5T system were included in this IRB-approved study. The protocol included T1w VIBE sequences acquired prior to (TP1), and 19 (TP2) and 150 (TP3) minutes after i.v. contrast injection. SNR measurements were performed by placing ROIs in each liver segment on identical positions of the corresponding datasets and compared (t-Test). Mean SNR changes (TP1-TP2; TP1-TP3) were calculated and correlated with liver functions tests (Spearman), which were obtained within 24 hours of the MRI scan, as well as with the MELD, AMSTERDAM and MAYO Score, respectively.

Significant changes of hepatic SNR between non-enhanced and gadoxetate disodium enhanced MRI could be observed in all liver segments (p<0.0001). Mean SNR prior to contrast injection was 79 (range 34-131), 19 min after contrast injection 166 (27-539) and 150 minutes p.i. 147 (43-296), respectively, corresponding with a mean SNR increase of 111% (TP2) and 93% (TP3). A significant correlation with serum bilirubin (p=0.0289), GOT (p=0.0178) and alkaline phosphatase (p=0.0004) could be appreciated (r=-0.322, -0.348 and -0.503, respectively). Significant correlations with the MELD (p=0.041; r=-0.303) and AMSTERDAM Score (p=0.013; r=-0.449) were observed.

On a segmental level, hepatic SNR significantly increased on gadoxetate disodium enhanced MRI in patients with PSC. Regarding the whole liver, the increase of SNR significantly correlated with clinical scores and liver functions tests. As fluctuations of these liver function tests are common during the course of the disease, SNR changes might probably reflect severity of the disease.

Hepatic SNR measurements in patients with PSC may serve as a useful method to assess liver function, on both a global and a segmental level. The segmental information might be useful to plan and guide endoscopic procedures.

Hinrichs, J, Lenzen, H, Wacker, F, Ringe, K, Value of Gadoxetate Disodium Enhanced MRI in Patients with Primary Sclerosing Cholangitis (PSC) for Assessment of Hepatic Function.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009085.html