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Assessment of Orthotopic Liver Transplant Graft Survival on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging Using Qualitative and Quantitative Parameters
- Source :
- Investigative Radiology. 51:728-734
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- The aim of this study was to evaluate the prognostic potential of a 3-parameter visual scoring (qualitative score [QS]) system for hepatobiliary phase gadoxetic acid-enhanced magnetic resonance imaging (MRI) in orthotopic liver transplant grafts.This retrospective study of 128 patients was approved by our institutional review board. Two readers independently assigned 3 QSs to T1-weighted MRI scans, 20 minutes after the administration of gadoxetic acid (hepatobiliary phase), based upon the following: (1) liver parenchymal enhancement (EnQS, 0-2); (2) biliary contrast excretion (ExQS, 0-2); and (3) signal intensity of the portal vein relative to the liver parenchyma, that is, the portal vein sign (PVsQS, 0-2). The functional liver imaging score (FLIS) was calculated as the sum score of these 3 parameters. The relative liver enhancement (RLE) was measured as well. Demographic, clinical, laboratory parameters, and imaging findings were included in univariate and multivariate statistical analyses. The primary end point was graft failure, that is, retransplantation or death from liver failure. The probability of graft survival was calculated by Kaplan-Meier estimates and Cox proportional hazards regression.In the univariate analysis, EnQS, ExQS, PVsQS, and FLIS scores, as well as RLE, were significantly associated with the 1- to 3-year probability of graft survival (P0.001). For a FLIS of (0), the 3-year probability of graft survival was 6.5%, whereas it was 51.3% for a FLIS of (1-3) and 100% for a FLIS of (4-6) (P0.001). In the multivariate survival models, EnQS, ExQS, and PVsQS, each independently outperformed the majority of clinical and laboratory parameters, and the FLIS did even better regarding the prediction of 1- to 3-year graft survival.In liver transplant recipients, gadoxetic acid-enhanced MRI-derived QSs (ie, EnQS, ExQS, and PVsQS), as well as the FLIS and RLE, can predict graft survival probability.
- Subjects :
- Gadolinium DTPA
Male
medicine.medical_specialty
Gadoxetic acid
medicine.medical_treatment
Contrast Media
Liver transplantation
030218 nuclear medicine & medical imaging
Cohort Studies
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Visual scoring
medicine
Humans
Radiology, Nuclear Medicine and imaging
Retrospective Studies
medicine.diagnostic_test
business.industry
Graft Survival
Reproducibility of Results
Orthotopic Liver Transplant
Magnetic resonance imaging
Retrospective cohort study
General Medicine
Middle Aged
Image Enhancement
Magnetic Resonance Imaging
Liver Transplantation
Liver
Hepatobiliary phase
Female
030211 gastroenterology & hepatology
Graft survival
Radiology
business
medicine.drug
Subjects
Details
- ISSN :
- 15360210 and 00209996
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Investigative Radiology
- Accession number :
- edsair.doi.dedup.....9d1f630128d0d696678c389269065baf
- Full Text :
- https://doi.org/10.1097/rli.0000000000000286