Role of Primovist-MR Imaging on Preoperative Assessment ment of the Risk of Postoperative Liver Failure in Patients with Hepatocellular Carcinoma

초록

Background: The aim of this study is to evaluate the role of gadoxetic acid&#8211;enhanced magnetic resonance (MR) imaging on preoperative assessment of the risk of postoperative liver failure(PLF) in hepatocellular carcinoma (HCC) patients using measurement of relative liver enhancement (RLE) on hepatobiliary phase images. Methods: A prospective cohort of 70 HCC patients were enrolled between November 2011 and April, 2014 in our institute. RLE was calculated as the ratio of signal intensity measurements of the liver parenchyma before and 20 minutes after intravenous administration of gadoxetic acid in each liver segment. PLF was defined based on the “50-50 criteria” (prothrombin time <50% and serum bilirubin >5mg/dL within postoperative 1 week). Results: Of the 70 patients, 47 (67.1%) patients had liver cirrhosis, clinically, but all of them were Child-Turcotte-Pugh class A. Median tumor size 2.6 cm (range, 1-14cm), 61 (87.1%) patients had a single HCC, and 64 (91.4%) patients had HCC within Milan criteria. Median value of indocyanine green R15 was 6.7 %. PLF was observed in 8 (5.4%) patients. Mean RLE was significantly lower in patients with PLF than those without it (62.6% vs. 94.7%, p<0.01). In a multivariate analysis, decreased RLE was a significant independent factor for PLF in HCC patients based on 50-50 rule Conclusions: Preoperative measurement of RLE using Primovist MR imaging can be useful for the assessment of postoperative liver failure in HCC patients. Disclosures: The following people have nothing to disclose: Sin-Il Kim, Young-Joo Jin, Soon Gu Cho, Ah Rhm Woo, Jin-Woo Lee, Young Soo Kim