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The differential diagnosis value of quantitative parameters of hepatobiliary phase from Gd-EOB-DTPA enhanced MRI in differentiating benign biliary strictures from malignant strictures
HU Jinghui  WANG Xiaoxiao  CHEN Junfei  LIU Jinyun  HUANG Jingcheng  SHI Binbin  FU Jianxiong  SUN Jun  LUO Xianfu 

Cite this article as: Hu JH, Wang XX, Chen JF, et al. The differential diagnosis value of quantitative parameters of hepatobiliary phase from Gd-EOB-DTPA enhanced MRI in differentiating benign biliary strictures from malignant strictures[J]. Chin J Magn Reson Imaging, 2022, 13(6): 117-121. DOI:10.12015/issn.1674-8034.2022.06.023.


[Abstract] Objective To investigate the differential diagnosis value for differentiating benign and malignant biliary strictures using quantitative parameters of hepatobiliary phase (HBP) from gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) enhanced MRI.Materials and methods The Gd-EOB-DTPA enhanced MRI images of 143 cases with biliary strictures were retrospectively analyzed, including 71 cases with benign strictures and 72 cases with malignant strictures. The relevant parameters of HBP enhancement ratio were calculated, including liver parenchyma enhancement ratio (LER), kidney medulla enhancement ratio (KER), corrected parameter of liver parenchyma enhancement ratio (LERc) and corrected parameter of kidney medulla enhancement ratio (KERc). Functional liver imaging score (FLIS) were calculated on HBP images from Gd-EOB-DTPA enhanced MRI. We compared the differences of relevant parameters of enhancement ratio, FLIS and related laboratory indexes between benign and malignant biliary strictures. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy in differentiating benign biliary strictures from malignant strictures using HBP quantitative parameters.Results LER of benign and malignant strictures was 73.4% (51.3%) and 36.2% (32.0%), respectively. LERc of benign and malignant strictures was (39.3±25.4)% and (12.0±15.3)%, respectively. The FLIS of benign and malignant biliary strictures was 5.0 (4.0) score and 2.0 (1.0) score, respectively. The differences were all statistically significant for above parameters (P＜0.001). The area under the curve (AUC) of LER was 0.769 in differentiating benign from malignant biliary strictures, and the AUC of LERc was 0.818. The AUC of FLIS in differentiating benign from malignant biliary strictures was 0.810. The AUC of combining LER and FLIS was 0.836. The AUC of combining LERc and FLIS was 0.851.Conclusions The parameters of hepatic enhancement ratio from HBP Gd-EOB-DTPA enhanced MRI and FLIS were both valuable in differentiating benign from malignant biliary strictures, with even better diagnostic efficiency on their combination.
[Keywords] Gd-EOB-DTPA；benign and malignant；biliary strictures；magnetic resonance imaging；quantitative parameters of hepatobiliary phase；functional liver imaging score；differential diagnosis

HU Jinghui1, 2   WANG Xiaoxiao1, 2   CHEN Junfei2, 3   LIU Jinyun2, 3   HUANG Jingcheng2, 3   SHI Binbin2   FU Jianxiong2   SUN Jun2   LUO Xianfu2*  

1 The Clinical Medicine College of Yangzhou University, Yangzhou 225001, China

2 Department of Medical Imaging, Northern Jiangsu People's Hospital, Yangzhou 225001, China

3 Dalian Medical University, Dalian 116031, China

Luo XF, E-mail: xianfu-luo@hotmail.com

Conflicts of interest   None.

Received  2021-11-21
Accepted  2022-05-27
DOI: 10.12015/issn.1674-8034.2022.06.023
Cite this article as: Hu JH, Wang XX, Chen JF, et al. The differential diagnosis value of quantitative parameters of hepatobiliary phase from Gd-EOB-DTPA enhanced MRI in differentiating benign biliary strictures from malignant strictures[J]. Chin J Magn Reson Imaging, 2022, 13(6): 117-121. DOI:10.12015/issn.1674-8034.2022.06.023.

[1]
Singh A, Gelrud A, Agarwal B. Biliary strictures: diagnostic considerations and approach[J]. Gastroenterol Rep (Oxf), 2015, 3(1): 22-31. DOI: 10.1093/gastro/gou072.
[2]
Kim DW, Kwon HJ, Kim KW, et al. Importance of imaging plane of gadoxetic acid: enhanced magnetic resonance cholangiography for bile duct anatomy in healthy liver donors[J]. Transplant Proc, 2021, 53(1): 49-53. DOI: 10.1016/j.transproceed.2020.08.008.
[3]
Suzuki T, Aonuma T, Oyama K, et al. High-resolution three-dimensional T1-weighted hepatobiliary MR cholangiography using Gd-EOB-DTPA for assessment of biliary tree anatomy: parallel imaging versus compressed sensing[J]. Eur J Radiol, 2021, 136: 109515. DOI: 10.1016/j.ejrad.2020.109515.
[4]
Ding C, Bai GJ. Advances in the evaluation of liver reserve function by Gd-EOB-DTPA-MRI[J]. Chin J Magn Reson Imaging, 2021, 12(8): 104-107. DOI: 10.12015/issn.1674-8034.2021.08.024.
[5]
Wang YJ, Zhang L, Ning J, et al. Preoperative remnant liver function evaluation using a routine clinical dynamic Gd-EOB-DTPA-enhanced MRI protocol in patients with hepatocellular carcinoma[J]. Ann Surg Oncol, 2021, 28(7): 3672-3682. DOI: 10.1245/s10434-020-09361-1.
[6]
Lee NK, Kim S, Lee JW, et al. Biliary MR imaging with Gd-EOB-DTPA and its clinical applications[J]. Radiographics, 2009, 29(6): 1707-1724. DOI: 10.1148/rg.296095501.
[7]
Feng ST, Wu L, Cai HS, et al. Cholangiocarcinoma: spectrum of appearances on Gd-EOB-DTPA-enhanced MR imaging and the effect of biliary function on signal intensity[J]. BMC Cancer, 2015, 15: 38. DOI: 10.1186/s12885-015-1039-x.
[8]
Liu YS, Cheng C, Zhou HB, et al. Comparison of Modified Child-pugh (MCP), Albumin-bilirubin (ALBI), and Child-pugh (CP) score for predicting of survival in Hepatocellular Carcinoma Patients Treated with Transcatheter Arterial Chemoembolization[J]. Bull Cancer, 2021, 108(10): 931-939. DOI: 10.1016/j.bulcan.2021.04.017.
[9]
Kamimura K, Fukukura Y, Yoneyama T, et al. Quantitative evaluation of liver function with T1 relaxation time index on Gd-EOB-DTPA-enhanced MRI: comparison with signal intensity-based indices[J]. J Magn Reson Imaging, 2014, 40(4): 884-889. DOI: 10.1002/jmri.24443.
[10]
Bastati N, Beer L, Mandorfer M, et al. Does the functional liver imaging score derived from gadoxetic acid-enhanced MRI predict outcomes in chronic liver disease?[J]. Radiology, 2020, 294(1): 98-107. DOI: 10.1148/radiol.2019190734.
[11]
Du YN, Lü ZB, Guan CS, et al. Value of FLIS derived from Gd-EOB-DTPA enhanced MRI in predicting liver function[J]. Biomed Eng Clin Med, 2020, 24(6): 682-686. DOI: 10.13339/j.cnki.sglc.20201023.023.
[12]
Hou YL, Gao MD, Guo HY, et al. Diagnostic value of albumin-bilirubin grade combined with serum ammonia in cirrhosis with hepatic encephalopathy[J]. Natl Med J China, 2018, 98(2): 127-131. DOI: 10.3760/cma.j.issn.0376-2491.2018.02.011.
[13]
Poetter-Lang S, Bastati N, Messner A, et al. Quantification of liver function using gadoxetic acid-enhanced MRI[J]. Abdom Radiol (NY), 2020, 45(11): 3532-3544. DOI: 10.1007/s00261-020-02779-x.
[14]
Talakic E, Steiner J, Kalmar P, et al. Gd-EOB-DTPA enhanced MRI of the liver: correlation of relative hepatic enhancement, relative renal enhancement, and liver to kidneys enhancement ratio with serum hepatic enzyme levels and eGFR[J]. Eur J Radiol, 2014, 83(4): 607-611. DOI: 10.1016/j.ejrad.2013.12.010.
[15]
Koh DM, Ba-Ssalamah A, Brancatelli G, et al. Consensus report from the 9 th International Forum for Liver Magnetic Resonance Imaging: applications of gadoxetic acid-enhanced imaging[J]. Eur Radiol, 2021, 31(8): 5615-5628. DOI: 10.1007/s00330-020-07637-4.
[16]
Song YP, Zhao QY, Li S, et al. Non-invasive fibrosis indexes in predicting acute liver function deterioration after transcatheter arterial chemoembolization[J]. Natl Med J China, 2016, 96(9): 716-719. DOI: 10.3760/cma.j.issn.0376-2491.2016.09.011.
[17]
Lourenço MS, Zitelli PMY, Cunha-Silva M, et al. Early liver function improvement following successful treatment of chronic hepatitis C in patients with decompensated cirrhosis: a real-life study[J]. Clinics (Sao Paulo), 2021, 76: e3186. DOI: 10.6061/clinics/2021/e3186.
[18]
Lian YQ, Xue X, Feng Z, et al. Gd-EOB-DTPA-enhanced MRI for evaluation of hepatic reserve function: the value of hepatic signal intensity and histogram in hepatobiliary phase[J]. Chin J Magn Reson Imaging, 2021, 12(10): 36-40. DOI: 10.12015/issn.1674-8034.2021.10.006.
[19]
Lee HJ, Hong SB, Lee NK, et al. Validation of functional liver imaging scores (FLIS) derived from gadoxetic acid-enhanced MRI in patients with chronic liver disease and liver cirrhosis: the relationship between Child-Pugh score and FLIS[J]. Eur Radiol, 2021, 31(11): 8606-8614. DOI: 10.1007/s00330-021-07955-1.
[20]
Tamada T, Ito K, Sone T, et al. Gd-EOB-DTPA enhanced MR imaging: evaluation of biliary and renal excretion in normal and cirrhotic livers[J]. Eur J Radiol, 2011, 80(3): e207-e211. DOI: 10.1016/j.ejrad.2010.08.033.

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