Dynamic-contrast-enhanced magnetic resonance imaging of cirrhotic liver parenchyma: A comparison between gadolinium-diethylenetriamine pentaacetic acid and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid.

BACKGROUND The newly developed magnetic-resonance-imaging (MRI) hepatocyte-specific contrast agent, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), has different excretion pathways from the conventional MRI contrast agent, gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). In this study, we compare the enhancement effect of the liver and renal parenchyma between these two contrast agents for patients with liver cirrhosis. METHODS We retrospectively included 49 consecutive patients with liver cirrhosis who underwent Gd-DTPA- and Gd-EOB-DTPA-enhanced MRIs within 3 months. We measured the signal intensity of the liver and kidney, and calculated the enhancement ratio (ER) in the arterial phase, portal venous phase, and venous phase (VP). We also calculated a delayed phase (DP) when Gd-DTPA was used, and a hepatocyte phase (HP) when Gd-EOB-DTPA was used. The ERs were compared between the two contrast agents. The effect of liver function on the ERs was also evaluated. RESULTS The ER of the liver with Gd-EOB-DTPA was significantly higher than with Gd-DTPA in the VP (p = 0.01) and in the HP/DP (p = 0.01). The ER of the kidney in the DP with Gd-DTPA was significantly higher than in the HP with Gd-EOB-DTPA (p < 0.001). The ERs of the liver using Gd-EOB-DTPA for patients with normal serum bilirubin were significantly higher than those with abnormal levels (p = 0.047), but there was no significant difference using Gd-DTPA. CONCLUSION The enhancement effect of the liver parenchyma using both MRI contrast agents was not affected by the degree of liver cirrhosis or abnormal liver function. However, it was affected by the serum-bilirubin levels in the Gd-EOB-DTPA-enhanced MRIs. Furthermore, enhancement of the liver was higher when using Gd-EOB-DTPA in the VP, DP, and HP. This knowledge is helpful when performing dynamic MRIs to diagnose focal hepatic lesions in the heterogeneous liver parenchyma.