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Sinusoidal obstruction syndrome. Axial 3D GRE T1W MR image obtained 20 min (hepatobiliary phase) following administration of gadoxetate disodium, in a 53-year-old man with history of ampullary adenocarcinoma on a chemotherapy regimen that included oxaliplatin, demonstrates heterogeneous reticular hypointense areas involving the periphery of the right hepatic lobe (arrow), presumably caused by sinusoidal obstruction syndrome
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Gadoxetate disodium (Gd-EOB-DTPA) is a linear, non-ionic paramagnetic MR contrast agent with combined extracellular and hepatobiliary properties commonly used for several liver indications. Although gadoxetate disodium is commonly used for detection and characterization of focal lesions, a spectrum of diffuse disease processes can affect the hepato...
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... Hepatobiliary function was assessed using 3D THRIVE images acquired before and after Gd-EOB-DTPA injection. Gd-EOB-DTPA is a hepatobiliary contrast agent that is taken up by hepatocytes (up to 50% of injected dose) and excreted in the bile by organic anion carriers that transport bilirubin (19,25,40,41). Gd-EOB-DTPA hepatic contrast enhancement is lower in the presence of hepatic impairment and/or increased blood bilirubin levels (25,41,42). ...
... Gd-EOB-DTPA is a hepatobiliary contrast agent that is taken up by hepatocytes (up to 50% of injected dose) and excreted in the bile by organic anion carriers that transport bilirubin (19,25,40,41). Gd-EOB-DTPA hepatic contrast enhancement is lower in the presence of hepatic impairment and/or increased blood bilirubin levels (25,41,42). Before analysis, MR images were uniformly scaled by using vendor-specific image scaling factors. ...
Severe liver impairment is a well-known hallmark of Ebola virus disease (EVD). However, the role of hepatic involvement in EVD progression is understudied. Medical imaging in established animal models of EVD (e.g., nonhuman primates [NHPs]) can be a strong complement to traditional assays to better investigate this pathophysiological process in vivo and noninvasively. In this proof-of-concept study, we used longitudinal multi-parametric magnetic resonance imaging (MRI) to characterize liver morphology and function in nine rhesus monkeys after exposure to Ebola virus (EBOV). Starting 5 days postexposure, MRI assessments of liver appearance, morphology, and size were consistently compatible with the presence of hepatic edema, inflammation, and congestion, leading to significant hepatomegaly at necropsy. MRI performed after injection of a hepatobiliary contrast agent demonstrated decreased liver signal on the day of euthanasia, suggesting progressive he-patocellular dysfunction and hepatic secretory impairment associated with EBOV infection. Importantly, MRI-assessed deterioration of biliary function was acute and progressed faster than changes in serum bilirubin concentrations. These findings suggest that longitudinal quantitative in vivo imaging may be a useful addition to standard biological assays to gain additional knowledge about organ pathophysiology in animal models of EVD. IMPORTANCE Severe liver impairment is a well-known hallmark of Ebola virus disease (EVD), but the contribution of hepatic pathophysiology to EVD progression is not fully understood. Noninvasive medical imaging of liver structure and function in well-established animal models of disease may shed light on this important aspect of EVD. In this proof-of-concept study, we used longitudinal magnetic resonance imaging (MRI) to characterize liver abnormalities and dysfunction in rhesus monkeys exposed to Ebola virus. The results indicate that in vivo MRI may be used as a noninvasive readout of organ pathophysiology in EVD and may be used in future animal studies to further characterize organ-specific damage of this condition, in addition to standard biological assays.
Background: Liver function assessment is very important in clinical practice. The possibility of using magnetic resonance imaging (MRI) as a method for anatomical and functional evaluation of the liver represents actual for clinical practice. Aims: This study aims to examine the possibility of using hepatobiliary contrast-enhanced MRI for evaluation of liver function. Materials and methods: Datasets of patients who underwent gadoxetic acid-enhanced MRI were retrospectively reviewed. The patients were divided into 2 groups: first one included patients with impaired liver function and the second one with normal liver function. Basing on MRI in hepatobiliary phase the following indexes were estimated: liver parenchyma signal intensity (LSI), ratio of LSI to spleen signal intensity (LSI/SSI) and ratio of LSI to portal vein signal intensity (LSI/VSI). Differences among these parameters were compared between groups. Correlation analysis was used to evaluate the correlation between LSI and laboratory blood tests reflecting liver function (total bilirubin (TB), albumen, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), prothrombin time (PT)). Results: Datasets of 53 patients (25 men and 28 women, aged 24 to 84 years) were analyzed. The first group included 19 people, the second – 34 people. Median of LSI was 919.05 [669.65;1258.35] in the first group and 1525.13 [1460.5;1631.4] in the second one (p=0.0000001), Median of LSI/SSI was 1.2 [1.04;1.7] in the first group and 1.7 [1.46;1.96] in the second one (p=0.00076). Median of LSI/VSI was 1.44 [1.29;1.83] in the first group and 1.6 [1.43;1.83] in the second one (p=0.1). Correlation between LSI and blood tests parameters (total bilirubin (r=-0.61; p=0.000001), albumen (r=0,13; p=0,61), AST (r=-0.57; p=0.000009), ALT (r= -0.44; p=0.001), ALP (r=-0.45; p=0.0007), GGT (r=-0.5; p=0.0003), PT (r=-0.34 ; p=0.04)) was estimated. Conclusions: The study reflects the ability to assess liver function using indices (LSI and LSI/SSI) derived from gadoxetic acid-enhanced MRI. This study did not confirm the assumption of the effectiveness of using the LSI/VSI index to evaluate liver function. A statistically significant inverse correlation was identified between LSI and blood tests parameters reflecting liver function, except albumen. The results indicate the possibility of MR-assessment of liver function.
