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World J Gastroenterol. May 7, 2017; 23(17): 3133-3141
Published online May 7, 2017. doi: 10.3748/wjg.v23.i17.3133
Diagnostic value of gadobenate dimeglumine-enhanced hepatocyte-phase magnetic resonance imaging in evaluating hepatic fibrosis and hepatitis
Xiu-Mei Li, Zhu Chen, En-Hua Xiao, Quan-Liang Shang, Cong Ma
Xiu-Mei Li, Zhu Chen, En-Hua Xiao, Quan-Liang Shang, Cong Ma, Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
Xiu-Mei Li, Department of Radiology, The First Affiliate Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Author contributions: Li XM, Chen Z and Xiao EH designed the research; Li XM, Chen Z and Ma C performed the research; Li XM and Shang QL analyzed the data; Li XM wrote the paper.
Supported by National Natural Science Foundation of China, Nos. 81571784 and 81601471; Scientific and Technological Support Project for Social Development of Hunan Province, No. 2015SF2020-4; Project of Development and Reform Commission of Hunan Province, No. Xiang Cai Enterprise Means [2015]83.
Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organization that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, "Diagnostic value of Gd-BOPTA-enhanced magnetic resonance imaging hepatocyte phase in evaluating hepatic fibrosis and hepatitis".
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: En-Hua Xiao, MD, Professor, Department of Radiology, The Second Xiangya Hospital of Central South University, No.139 Ren Min Zhong Lu, Fu Rong District, Changsha 410011, Hunan Province, China. cjr.xiaoenhua@vip.163.com
Telephone: +86-731-85292116
Received: September 22, 2016
Peer-review started: September 23, 2016
First decision: December 19, 2016
Revised: January 16, 2017
Accepted: March 15, 2017
Article in press: March 15, 2017
Published online: May 7, 2017
Processing time: 226 Days and 2.6 Hours
Abstract
AIM

To evaluate the diagnostic value of gadobenate dimeglumine (Gd-BOPTA)-enhanced hepatocyte-phase magnetic resonance imaging (MRI) in evaluating hepatic fibrosis and hepatitis.

METHODS

Hepatocyte-phase images of Gd-BOPTA-enhanced MRI were retrospectively evaluated in 76 patients with chronic liver disease. These patients were classified into five groups according to either the histopathological fibrosis stage (S0-S4) or the histopathological hepatitis grade (G0-G4). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated by measuring the signal intensity before (SI pre) and 90 min after (SI post) intravenous injection of Gd-BOPTA using the following formula: RE = (SI post - SI pre)/SI pre. One-way analysis of variance was used to compare the difference between the relative RE in the hepatocyte phase (REh) and the stage of hepatic fibrosis and the grade of hepatitis. Pearson’s product-moment correlation analysis was used to evaluate the relationship between the REh and the levels of serologic liver functional parameters.

RESULTS

According to histopathological hepatic fibrosis stage, the 76 patients were classified into five groups: 16 in S0, 15 in S1, 21 in S2, 9 in S3, and 15 in S4 group. According to histopathological hepatitis grade, the 76 patients were also classified into five groups: 0 in G0, 44 in G1, 22 in G2, 8 in G3, and 2 in G3 group. With regard to the stage of hepatic fibrosis, REh showed significant differences between the S2 and S3 groups and between the S2 and S4 groups (P < 0.05), but no significant difference was observed between the other groups. With regard to the grade of hepatitis, REh showed significant differences between the G1 and G2 groups and between the G1 and G4 groups (P < 0.05), but no significant difference was observed between the other groups. Increased REh showed correlations with decreased serum levels of TB, ALT and AST (P < 0.05).

CONCLUSION

To some extent, measuring the REh using Gd-BOPTA-enhanced MRI might be a noninvasive technique for assessing the stage of hepatic fibrosis. This method is able to differentiate no/mild hepatitis from advanced hepatitis. TB, ALT and AST levels can predict the degree of liver enhancement in the hepatocyte phase of Gd-BOPTA-enhanced MRI.

Keywords: Gd-BOPTA, Magnetic resonance imaging, Hepatocyte phase, Relative enhancement, Hepatic fibrosis

Core tip: A crucial issue in the prognosis and management of chronic liver diseases is the extent and the progression of hepatic fibrosis. The percutaneous liver biopsy is a widely adopted classical method to diagnose hepatic fibrosis, but it is invasive. We use the degree enhancement in the hepatocyte phase of Gd-BOPTA-enhanced magnetic resonance imaging to evaluate the liver condition of patients with chronic liver diseases. This method is recommended because of advantages such as no injury to the patient and possibility to assess the stage of hepatic fibrosis, the degree of hepatitis and the liver function.