Objectives: To qualitatively evaluate late dynamic contrast phases, 10, 20 and 30 min, after administration of Gd-EOB-DTPA with regard to biliary excretion in patients presenting with elevated liver enzymes without clinical signs of cirrhosis or hepatic decompensation and to compare the visual assessment of contrast agent excretion with histo-pathological fibrosis stage, contrast uptake parameters and blood tests.
Methods: 29 patients were prospectively examined using 1.5 T MRI. The visually assessed presence or absence of contrast agent for each of five anatomical regions in randomly reviewed time-series was summarized on a four grade scale for each patient. The scores, including a total visual score, were related to the histo-pathological findings, the quantitative contrast agent uptake parameters, expressed as K Hep or LSC_N, and blood tests.
Results: No relationship between the fibrosis grade or contrast uptake parameters could be established. A negative correlation between the visual assessment and alkaline phosphatase (ALP) was found. Comparing a sub-group of cholestatic patients with fibrosis score and Gd-EOB-DTPA dynamic parameters did not add any additional significant correlation.
Conclusions: No correlation between visually assessed biliary excretion of Gd-EOB-DTPA and histo-pathological or contrast uptake parameters was found. A negative correlation between the visual assessment and alkaline phosphatase (ALP) was found.
Keywords: AAT deficiency, α1-antitrypsin deficiency; AIH, autoimmune hepatitis; ALP, alkaline phosphatase; ALT, alanine aminotransferase; AUROC, area under the receiver operating characteristic curve; Bile; CLD, chronic liver disease; DCE-MRI, Dynamic Contrast Enhanced Magnetic Resonance Imaging; DILI, drug induced liver injury; Dynamic contrast enhanced MRI; Excretion; FA, flip angle; Gd-EOB-DTPA; Gd-EOB-DTPA, gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid; HCV, hepatitis C; KHep, contrast uptake rate; LSC_N, normalised liver-to-spleen contrast ratio; Liver; MANA, multi scale adaptive normalizing averaging; MRP, multidrug resistance protein; NAFLD, non-alcoholic fatty liver disease; OATP, organic anion transporting polypeptides; PSC, primary sclerosing cholangitis; RE, relative enhancement; SNR, signal to noise ratio.