2. Cleveland Clinic Abu Dhabi Digestive Disease Institute, UAE.
3. Cleveland Clinic Abu Dhabi Research Department, UAE.
4. National Reference Laboratory, UAE.
5. Abdominal Transplant Center, Cleveland Clinic Florida, Weston, USA.
Purpose: Currently used prognostic models in cirrhosis rely on clinical and laboratory criteria. Quantitative MRI estimation of liver function could determine degree of hepatic synthetic function impairment and could consequently be used as a prognostic tool in patients with cirrhosis. Our aim was to estimate liver function using MRI and assess its correlation with MELD-Na score, an established laboratory-based prognostic model in cirrhosis.
Methods: 52 subjects without liver disease (controls) and 79 patients with cirrhosis were retrospectively evaluated. Patients with cirrhosis were stratified based on MELD-Na scores into the following groups: 6-10, 11-17, 18-24 and 25-40. All subjects underwent MRI with hepatobiliary contrast agent Gadoxetic acid (GdEOB) and T1 relaxation time map of all subjects were created for pre and postcontrast images. The T1 time ratio between pre- and postcontrast hepatobiliary phase images were determined in all study subjects and correlated with MELD-Na scores in patients with cirrhosis.
Results: The average T1 ratio in healthy controls was 0.83. The average T1 ratios in patients with MELDNa scores of 6-10, 11-17, 18-24 and 25-40 were 0.79, 0.69, 0.58 and 0.50 respectively. There was significant difference between T1 ratios in controls without liver disease and patients with cirrhosis (p<0.001). Moreover, T1 ratios among patients with cirrhosis increased with each successive range of MELD-Na scores (p<0.001).
Conclusion: The T1 map MR estimation of liver function with the use of hepatobiliary contrast agent correlates well with established prognostic models in cirrhosis and could be a valuable adjunct to currently available clinical tools to estimate liver function and thereby enable prognostication in patients with cirrhosis.
Keywords: Liver, Function, MRI, Cirrhosis, Hepatobiliary Contrast