Non-focal liver signal abnormalities on hepatobiliary phase of gadoxetate disodium-enhanced MR imaging: a review and differential diagnosis

Abstract

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 hepatobiliary phase of imaging (i.e., when contrast accumulates within the hepatocytes). Non-focal signal abnormalities during the hepatobiliary phase can be seen with multiple disease processes such as deposition disorders, infiltrating tumors, vascular diseases, and post-treatment changes. The purpose of this paper is to review the different processes which result in non-focal signal alteration during the hepatobiliary phase and to describe imaging patterns that may order a differential diagnosis and facilitate patient management.

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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.…”