Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI.

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Bibliographic Details
Title:	Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI.
Authors:	Geisel, Dominik¹ dominik.geisel@charite.de, Lüdemann, Lutz², Keuchel, Thomas³, Malinowski, Maciej³, Seehofer, Daniel³, Stockmann, Martin³, Hamm, Bernd¹, Gebauer, Bernhard¹, Denecke, Timm¹
Source:	European Radiology. Sep2013, Vol. 23 Issue 9, p2555-2560. 6p. 1 Diagram, 1 Chart, 3 Graphs.
Subjects:	Liver, Portal vein, Therapeutic embolization, Hepatectomy, Gadolinium, Surgical excision, Magnetic resonance imaging
Abstract:	Objectives: To prospectively evaluate the early development of regional liver function after right portal vein embolisation (PVE) with Gd-EOB-DTPA-enhanced MRI in patients scheduled for extended right hemihepatectomy. Methods: Ten patients who received a PVE before an extended hemihepatectomy were examined before and 14 days after PVE using Gd-EOB-DTPA-enhanced MRI of the liver. In these sequences representative region of interest measurements were performed in the embolised right (RLL) and the non-embolised left liver lobe (LLL). The volume as well as hepatic uptake index (HUI) was calculated independently for each lobe. Results: Relative enhancement 14 days after PVE decreased in the RLL and increased significantly in the LLL ( P < 0.05). Average hepatic uptake index (HUI) for RLL was significantly lower 14 days after PVE than before PVE ( P < 0.05) and significantly higher for LLL ( P < 0.05). Conclusions: A significant shift of contrast uptake from the right to the left liver lobe can be depicted as early as 14 days after right PVE by using Gd-EOB-DTPA-enhanced MRI, which could reflect the redirected portal venous blood flow and the rapid utilisation of a hepatic functional reserve. Key Points: • Preoperative portal vein embolisation (PVE) is widely performed before right-sided hepatic resection. • PVE increases intravenous contrast medium uptake in the left lobe of liver. • The hepatic uptake index for the left liver lobe increases rapidly after PVE. • Left liver lobe function increase may be visualised by Gd-EOB-DTPA-enhanced MRI. [ABSTRACT FROM AUTHOR]
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Database:	Engineering Source

Description
Abstract:	Objectives: To prospectively evaluate the early development of regional liver function after right portal vein embolisation (PVE) with Gd-EOB-DTPA-enhanced MRI in patients scheduled for extended right hemihepatectomy. Methods: Ten patients who received a PVE before an extended hemihepatectomy were examined before and 14 days after PVE using Gd-EOB-DTPA-enhanced MRI of the liver. In these sequences representative region of interest measurements were performed in the embolised right (RLL) and the non-embolised left liver lobe (LLL). The volume as well as hepatic uptake index (HUI) was calculated independently for each lobe. Results: Relative enhancement 14 days after PVE decreased in the RLL and increased significantly in the LLL ( P < 0.05). Average hepatic uptake index (HUI) for RLL was significantly lower 14 days after PVE than before PVE ( P < 0.05) and significantly higher for LLL ( P < 0.05). Conclusions: A significant shift of contrast uptake from the right to the left liver lobe can be depicted as early as 14 days after right PVE by using Gd-EOB-DTPA-enhanced MRI, which could reflect the redirected portal venous blood flow and the rapid utilisation of a hepatic functional reserve. Key Points: • Preoperative portal vein embolisation (PVE) is widely performed before right-sided hepatic resection. • PVE increases intravenous contrast medium uptake in the left lobe of liver. • The hepatic uptake index for the left liver lobe increases rapidly after PVE. • Left liver lobe function increase may be visualised by Gd-EOB-DTPA-enhanced MRI. [ABSTRACT FROM AUTHOR]
ISSN:	09387994
DOI:	10.1007/s00330-013-2859-1