Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid

Figure 1 Gadoxetic acid contrast-enhanced magnetic resonance images obtained in a 46-year-old woman with normal liver. Contrast-enhanced magnetic resonance images show a stepwise intensity increase of the liver parenchyma from the hepatic arterial phase to hepatobiliary phase. On hepatic arterial and portal venous phases (vascular phase), the intrahepatic vessels show intense and homogeneous enhancement. On 3 min late and 5 min late phases (transitional phase), the intrahepatic vessels (open arrows) show isointensity to the liver, indicating the transition of gadoxetic acid from the extra-cellular spaces to the hepatocellular-spaces. On 10 min and 20 min phase (hepatobiliary phase), the intrahepatic vessels show hypointensity to the liver, while the bile ducts (arrows) show hyperintensity; these findings indicate an adequate hepatobiliary phase. Also note kidney hypointensity to the liver, which indicates normal hepatobiliary elimination of gadoxetic acid and adequate hepatobiliary phase. PRE: Precontrast; HAP: Late hepatic arterial phase; PVP: Portal venous phase.