Format

Send to

Choose Destination
Eur Radiol. 2017 Jul;27(7):3080-3087. doi: 10.1007/s00330-016-4674-y. Epub 2016 Dec 13.

Gd-EOB-DTPA-enhanced MRI for monitoring future liver remnant function after portal vein embolization and extended hemihepatectomy: A prospective trial.

Author information

1
Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. dominik.geisel@charite.de.
2
Department of Diagnostic and Interventional Radiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
3
Department of Medical Physics, Essen University Hospital, Essen, Germany.
4
Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.

Abstract

OBJECTIVES:

To evaluate changes in liver function after right portal vein embolization (PVE) and extended right hemihepatectomy using gadolinium ethoxybenzyl-DTPA-enhanced (Gd-EOB-DTPA) MRI.

METHODS:

In this prospective trial, 37 patients undergoing PVE were examined before and 14 and 28 days after PVE and 10 days after extended hemihepatectomy using Gd-EOB-DTPA-enhanced MRI. Lobar volume, kinetic growth rate (KGR), relative enhancement (RE) as well as hepatocellular uptake index (HUI) and fat signal fraction (FSF) were calculated for each lobe.

RESULTS:

RE of the left liver lobe (LLL) was steadily increasing after PVE and decreased to 0.48 ± 0.19 10 days after surgery, which is significantly lower than 14 days and 28 days post PVE (P < 0.05). KGR was 14.06 ± 9.82%/week for the period from PVE to 14 days after PVE. HUI of the LLL increased steadily after PVE and was significantly higher at both 14 and 28 days after PVE compared to pre PVE (P < 0.05). HUI of the residual liver after surgery was lower than before.

CONCLUSIONS:

Gd-EOB-DTPA-enhanced MRI may be used to monitor the functional increase in the FLR after PVE and to depict the intraoperative liver injury leading to a decrease in liver remnant function.

KEY POINTS:

• The most significant FLR volume increase happens within the first 14 days. • No MRI parameter was able to predict the success of FLR growth. • Our data suggest an early resection about 14 days after PVE. • Routine Gd-EOB-DTPA-enhanced MRI might be suitable to replace ICG-test.

KEYWORDS:

Gadolinium ethoxybenzyl DTPA; Liver; Liver function tests; Magnetic resonance imaging; Portal vein embolization

PMID:
27966044
DOI:
10.1007/s00330-016-4674-y
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center