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Contrast enhanced liver MRI in patients with primary sclerosing cholangitis: inverse appearance of focal confluent fibrosis on delayed phase MR images with hepatocyte specific versus extracellular gadolinium based contrast agents.

Publication ,  Journal Article
Husarik, DB; Gupta, RT; Ringe, KI; Boll, DT; Merkle, EM
Published in: Acad Radiol
December 2011

RATIONALE AND OBJECTIVES: To assess the enhancement pattern of focal confluent fibrosis (FCF) on contrast-enhanced hepatic magnetic resonance imaging (MRI) using hepatocyte-specific (Gd-EOB-DTPA) and extracellular (ECA) gadolinium-based contrast agents in patients with primary sclerosing cholangitis (PSC). MATERIALS AND METHODS: After institutional review board approval, 10 patients with PSC (6 male, 4 female; 33-61 years) with 13 FCF were included in this retrospective study. All patients had a Gd-EOB-DTPA-enhanced liver MRI exam, and a comparison ECA-enhanced MRI. On each T1-weighted dynamic dataset, the signal intensity (SI) of FCF and the surrounding liver as well as the paraspinal muscle (M) were measured. In the Gd-EOB-DTPA group, hepatocyte phase images were also included. SI FCF/SI M, SI liver/SI M, and [(SI liver - SI FCF)/SI liver] were compared between the different contrast agents for each dynamic phase using the paired Student's t-test. RESULTS: There was no significant difference in SI FCF/SI M in all imaging phases. SI liver/SI M was significantly higher for the Gd-EOB-DTPA group in the delayed phase (P < .001), whereas there was no significant difference in all other imaging phases. In the Gd-EOB-DTPA group, mean [(SI liver - SI FCF)/SI liver] were as follows (values for ECA group in parentheses): unenhanced phase: 0.26 (0.26); arterial phase: 0.01 (-0.31); portal venous phase (PVP): -0.05 (-0.26); delayed phase (DP): 0.14 (-0.54); and hepatocyte phase: 0.26. Differences were significant for the DP (P < .001). CONCLUSIONS: On delayed phase MR images the FCF-to-liver contrast is reversed with the lesions appearing hyperintense on ECA enhanced images and hypointense on Gd-EOB-DTPA-enhanced images.

Duke Scholars

Published In

Acad Radiol

DOI

EISSN

1878-4046

Publication Date

December 2011

Volume

18

Issue

12

Start / End Page

1549 / 1554

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Liver
  • Image Enhancement
  • Humans
  • Hepatocytes
  • Gadolinium DTPA
 

Citation

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MLA
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Husarik, D. B., Gupta, R. T., Ringe, K. I., Boll, D. T., & Merkle, E. M. (2011). Contrast enhanced liver MRI in patients with primary sclerosing cholangitis: inverse appearance of focal confluent fibrosis on delayed phase MR images with hepatocyte specific versus extracellular gadolinium based contrast agents. Acad Radiol, 18(12), 1549–1554. https://doi.org/10.1016/j.acra.2011.08.007
Husarik, Daniela B., Rajan T. Gupta, Kristina I. Ringe, Daniel T. Boll, and Elmar M. Merkle. “Contrast enhanced liver MRI in patients with primary sclerosing cholangitis: inverse appearance of focal confluent fibrosis on delayed phase MR images with hepatocyte specific versus extracellular gadolinium based contrast agents.Acad Radiol 18, no. 12 (December 2011): 1549–54. https://doi.org/10.1016/j.acra.2011.08.007.
Journal cover image

Published In

Acad Radiol

DOI

EISSN

1878-4046

Publication Date

December 2011

Volume

18

Issue

12

Start / End Page

1549 / 1554

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Liver
  • Image Enhancement
  • Humans
  • Hepatocytes
  • Gadolinium DTPA