Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors

Purpose: To identify factors influencing hepatobiliary phase (HBP) hepatic enhancement on gadoxetate disodium-enhanced MRI in patients with chronic liver disease (CLD). Materials and Methods: We retrospectively reviewed abdominal gadoxetate disodium-enhanced MRIs and medical records of patients with (n = 97) and without (n = 48) CLD. CLD subgroups were formed based on normal/abnormal components of liver function tests (LFTs). Hepatic enhancement coefficients (HEKs) were calculated on MRI, and compared with LFTs and Model for End-stage Liver Disease (MELD) scores. Results: The mean HEK was significantly lower (P < 0.0008) in the CLD than control group. The mean HEK was similar to controls in the subgroup with all normal LFTs (P = 0.09) and subgroup with normal direct bilirubin (DB) (p = 0.09), while it was significantly reduced (P < 0.0001) in the subgroup with elevated DB. For all other LFT components, regardless of normal or abnormal values, there was a significant reduction in the mean HEKs versus controls (all P values <0.01). There was a highly negative correlation between the mean HEKs in CLD subgroups and number of abnormal LFTs (r = -0.93) and MELD scores (r = -0.89). Conclusion: HBP hepatic enhancement in CLD patients is similar to those with no CLD as long as direct bilirubin remains normal. Higher MELD scores and higher number of abnormal LFT components are associated with reduced hepatic enhancement.