Quantitative Evaluation of the Hepatic Parenchymal Change in Patients with Chronic Liver Disease Using Gd-EOB-DTPA-enhanced MRI: Comparison with Normal Liver

Abstract

Department of Diagnostic Radiology, Korea University Ansan Hospital Received July 6, 2010; Accepted October 14, 2010 Address reprint requests to : Sang Hoon Cha, M.D., Department of Diagnostic Radiology, Korea University Ansan Hospital, 516, Gojan-dong, Ansan-city, Gyeonggi-do 425-707, Korea. Tel. 82-31-412-5227 Fax. 82-31-412-5224 E-mail: sahcha@kumc.or.kr Purpose: We wanted to evaluate the capability of Gd-EOB-DTPA-enhanced MRI for diagnosing chronic liver disease by comparing the signal intensity change (SIC) of the hepatic parenchyma of patients with chronic liver disease with that of patients with a normal liver. Materials and Methods: This retrospective study included 50 patients who were pathologically confirmed as having liver cirrhosis (n=41) or chronic hepatitis (n=9) by surgery (n=9) or biopsy (n=41), and they all underwent Gd-EOB-DTPA-enhanced MRI between June 2008 and May 2010 (i.e., the patient group). We also analyzed 30 patients with normal livers as the control group. Quantitative image analysis was performed by measuring the signal-to-noise ratios for the pre-contrast images and the post-contrast 2-, 3-, 10-, 20-min delay images and then calculating the SIC of the precontrast and post-contrast images. We performed a detailed analysis of the collected data, which was transformed into a logarithmic form. The SICs of the two groups were compared by Greenhouse-Geisser sphericity correction. Results: Comparison of the SIC between the two groups showed a significant difference on the hepatocyte-phase 20-min image (p<0.0001). The mean SICs with log transformation for the patient and normal groups were 1.90 ± 0.10 and 2.23 ± 0.13, respectively, and the optimal cut-off value of the SIC with log transformation on the 20-min delay hepatocyte-phase image was 2.17 (sensitivity: 66.7%, specificity: 84.0%, positive predictive value: 71.4%, negative predictive value: 80.8%). Conclusion: Quantitative measurement of the SIC on the hepatocyte-phase image by Gd-EOB-DTPA-enhanced MRI could provide a convenient method to noninvasively diagnose chronic liver disease.