MnDPDP enhancement characteristics and differentiation between cirrhotic and noncirrhotic livers

The objective was to analyze if liver enhancement with mangafodipir trisodium was influenced by liver cirrhosis.

Eighty patients (49 with cirrhotic and 31 with noncirrhotic livers) were studied with spin-echo and spoiled gradient-echo T1-weighted images, before and after administration of mangafodipir trisodium. Hepatic insufficiency was assessed using the Child classification. Image analysis was performed both qualitatively and quantitatively.

Noncirrhotic livers enhanced homogeneously but 37% of cirrhotic livers did not; the difference was significant. Areas corresponding to collapsed fibrous zones enhanced less than the rest of the parenchyma; areas of regenerating nodular zones enhanced more. Signal-to-noise ratios were significantly less for cirrhotic livers on postcontrast spoiled gradient-echo images. Cirrhotic livers had significantly lower relative enhancement ratios than noncirrhotic ones. The Child index and aspartate aminotransferase values were statistically related to the enhancement ratio.

Mangafodipir trisodium enhancement in cirrhotic livers is related to necrosis and regeneration of the hepatocytes. Cirrhotic livers enhanced less than noncirrhotic ones.