Study of dynamic gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhancement characteristic and influence factors in patients with cirrhosis

Objective To study the characteristics and influence factors of dynamic multi-phase gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI in patients with cirrhosis. Methods A total of 229 patients with diagnosis of cirrhosis or without cirrhosis were examed with dynamic multi-phase Gd-EOB-DTPA enhanced MRI at arterial phase (delay 30 s), portal phase (delay 60 s), and hepatobiliary phase (delay 3, 5, 10, 20, 30 and 60 min). The subjects included 92 patients without cirrhosis and 137 patients with cirrhosis (the grade was Child-Pugh class A in 89 patients, class B in 37 patients, and class C in 11 patients). The characteristic of dynamic multi-phase enhancement was evaluated and the relative enhancement ratio of liver was calculate. The difference of RE between patients without and with cirrhosis was compared by student's t test. ANOVA was used to analyze the difference of RE among different degrees of Child-Pugh classification. Results The downtrend of RE was found from 3 to 10 min in patients both with and without cirrhosis, the uptrend of RE was found from 10 to 30 min in both groups. From 30 to 60 min, the slow uptrend of RE was found in patients without cirrhosis, while the slow downtrend was found in patients with cirrhosis. There was statistical difference in RE at hepatobiliary phase of 20, 30 and 60 min between the groups with and without cirrhosis (P 0.05). REs were 1.22±0.16 and 1.28±0.19 at 20 and 30 min in patients with cirrhosis, and were 1.43±0.11 and 1.53±0.16 in patients without cirrhosis, respectively. There was statistical difference in RE between hepatobiliary phase at 20 min and 30 min in both groups (t values were -4.01 and -3.80,P 0.05). The RE decreased continuously from 3 to 60 min in group of Child-Pugh class C. Conclusions Dynamic multi-phase Gd-EOB-DTPA enhanced MRI can be preliminarily used to assess the patients with cirrhosis. RE can be elevated as long as delaying the hepatobiliary-phase time to 30 min, but this effect is limited by severe liver function damage. Key words: Cirrhosis; Contrast media; Magnetic resonance imaging