Gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)- enhanced magnetic resonance imaging with various enhancement ratios: a correlation with clinical assessment of liver function using the Child-Pugh scoring system

Introduction
Liver cirrhosis has been becoming a major cause of mortality in developed countries. Recently, the increasing role of magnetic resonance imaging (MRI) in the diagnosis of liver cirrhosis has been emphasized. For grading of liver fibrosis, various quantitative parameters have been proposed, such as contrast enhancement index (CEI), contrast enhancement ratio (CER), liver-to-muscle ratio (LMR) and liver-to-spleen ratio (LSR). Their role in the assessment of the liver function has not yet been thoroughly investigated.

Aim of the research: To determine whether there is a correlation between hepatocyte-specific contrast-enhanced MRI and liver function impairment classified by the Child-Pugh scoring system in patients with cirrhosis thirty two.

Material and methods
Ninety four patients with cirrhosis and thirty two patients with clinically healthy liver who underwent gadolinium ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging were enrolled in this study. Patients from the study group were divided into three subgroups according to the Child-Pugh scoring system. The values of all four enhancement ratios (CEI, CER, LMR and LSR) were compared between groups.

Results
The mean values of all four parameters were significantly lower in patients with moderate or severe liver function impairment (Child-Pugh B and Child-Pugh C) than in patients with mild impairment (Child-Pugh A). Amongst all parameters, CER and LMR showed the best correlation with liver function impairment (r = –0.57 and r = –0.58, respectively).

Conclusions
Our study showed a good correlation between quantitative evaluation of the liver function using Gd-EOB-DTPA MR imaging and clinical assessment in patients with cirrhosis.