Korean J Radiol.  2017 ;18(4):682-690. 10.3348/kjr.2017.18.4.682.

Tâ‚‚* Mapping from Multi-Echo Dixon Sequence on Gadoxetic Acid-Enhanced Magnetic Resonance Imaging for the Hepatic Fat Quantification: Can It Be Used for Hepatic Function Assessment?

• Yoo H
• Lee JM
• Yoon JH
• Kang HJ
• Lee SM
• Yang HK
• Han JK

• KMID: 2427237
• DOI: http://doi.org/10.3348/kjr.2017.18.4.682

Abstract

OBJECTIVE
To evaluate the diagnostic value of Tâ‚‚* mapping using 3D multi-echo Dixon gradient echo acquisition on gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) as a tool to evaluate hepatic function.
MATERIALS AND METHODS
This retrospective study was approved by the IRB and the requirement of informed consent was waived. 242 patients who underwent liver MRIs, including 3D multi-echo Dixon fast gradient-recalled echo (GRE) sequence at 3T, before and after administration of gadoxetic acid, were included. Based on clinico-laboratory manifestation, the patients were classified as having normal liver function (NLF, n = 50), mild liver damage (MLD, n = 143), or severe liver damage (SLD, n = 30). The 3D multi-echo Dixon GRE sequence was obtained before, and 10 minutes after, gadoxetic acid administration. Pre- and post-contrast Tâ‚‚* values, as well as Tâ‚‚* reduction rates, were measured from Tâ‚‚* maps, and compared among the three groups.
RESULTS
There was a significant difference in Tâ‚‚* reduction rates between the NLF and SLD groups (−0.2 ± 4.9% vs. 5.0 ± 6.9%, p = 0.002), and between the MLD and SLD groups (3.2 ± 6.0% vs. 5.0 ± 6.9%, p = 0.003). However, there was no significant difference in both the pre- and post-contrast Tâ‚‚* values among different liver function groups (p = 0.735 and 0.131, respectively). A receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve for using Tâ‚‚* reduction rates to differentiate the SLD group from the NLF group was 0.74 (95% confidence interval: 0.63-0.83).
CONCLUSION
Incorporation of Tâ‚‚* mapping using 3D multi-echo Dixon GRE sequence in gadoxetic acid-enhanced liver MRI protocol may provide supplemental information for liver function deterioration in patients with SLD.

Keyword

Liver fibrosis; Liver cirrhosis; Gadoxetic acid; Tâ‚‚* map; Râ‚‚*; MRI; Hepatic fat quantification

MeSH Terms

Adult
Aged
Aged, 80 and over
Area Under Curve
Contrast Media/*chemistry
Female
Gadolinium DTPA/*chemistry
Humans
Liver Cirrhosis/diagnostic imaging
Liver Diseases/*diagnostic imaging
Liver Function Tests
*Magnetic Resonance Imaging
Male
Middle Aged
ROC Curve
Retrospective Studies
Young Adult
Contrast Media
Gadolinium DTPA

Figure

• 

  Fig. 1 Flow diagram of study population.GRE = gradient-recalled echo

• 

  Fig. 2 T2* values were calculated in pre- and post-contrast T2* maps by drawing three circular ROIs in liver parenchyma while avoiding focal hepatic lesions, major branches of portal or hepatic veins, or imaging artifacts.ROIs were placed in same position in liver for both pre- and post-contrast T2* maps. ROIs = regions of interest

• 

  Fig. 3 Pre- and post-contrast T2* values (A) and reduction rates (B) in each group were visualized through box-plot.Dark line in middle of boxes denotes median T2* value, bottom of box indicates 25th percentile, and top of box indicates 75th percentile. Circle denotes outliers that are farther than 1.5 interquartile ranges, yet closer than 3 interquartile ranges, while star denotes extreme outliers that are greater than 3 interquartile ranges. MLD = mild liver disease, NLF = normal liver function, SLD = severe liver disease

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