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

Figure 3 Gadoxetic acid contrast-enhanced magnetic resonance images obtained in a 57-year-old man with Child-Pugh C hepatitis C virus-related cirrhosis. Contrast-enhanced magnetic resonance images show slight decrease of liver enhancement after the portal venous phase. On hepatic arterial and portal venous phases, the intrahepatic vessels show intense and homogeneous enhancement, which persists on 3 min, 5 min, and 10 min phase. On 20 min phase, the intrahepatic vessels show isointensity to the liver. Prolonged retention of the contrast in intrahepatic vessels indicates impaired hepatic function and an inadequate hepatobiliary phase. Twenty minutes phase corresponds in this case to the transitional phase observed in normal liver patient due to prolonged retention of gadoxetic acid in intrahepatic vessels. Also, note that the kidney shows isointensity to the liver on 10 min and 20 min phases, indicating a compensatory increase of renal elimination of gadoxetic acid and an inadequate hepatobiliary phase. PRE: Precontrast; HAP: Late hepatic arterial phase; PVP: Portal venous phase.