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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2016; 22(1): 103-111
Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.103
Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid
Francesco Agnello, Marco Dioguardi Burgio, Dario Picone, Federica Vernuccio, Giuseppe Cabibbo, Lydia Giannitrapani, Adele Taibbi, Antonino Agrusa, Tommaso Vincenzo Bartolotta, Massimo Galia, Roberto Lagalla, Massimo Midiri, Giuseppe Brancatelli
Francesco Agnello, Marco Dioguardi Burgio, Dario Picone, Federica Vernuccio, Adele Taibbi, Tommaso Vincenzo Bartolotta, Massimo Galia, Roberto Lagalla, Massimo Midiri, Giuseppe Brancatelli, Section of Radiological Sciences, DIBIMED, University of Palermo, 90127 Palermo, Italy
Giuseppe Cabibbo, Section of Gastroenterology, DIBIMIS, University of Palermo, 90127 Palermo, Italy
Lydia Giannitrapani, Section of Internal Medicine, DIBIMIS, University of Palermo, 90127 Palermo, Italy
Antonino Agrusa, Department of General Surgery, Urgency, and Organ Transplantation, University of Palermo, 90127 Palermo, Italy
Author contributions: Agnello F and Brancatelli G were guarantors of integrity for entire study; Agnello F, Dioguardi Burgio M, Galia M, Midiri M and Brancatelli G wrote and revised the manuscript for important intellectual content; Agnello F, Picone D, Vernuccio F, Giannitrapani L and Taibbi A performed the literature research; Agnello F, Cabibbo G, Agrusa A, Bartolotta TV, Lagalla R and Brancatelli G edited the manuscript; and all authors approve the final version of submitted manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giuseppe Brancatelli, MD, Section of Radiological Sciences, DIBIMED, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy. gbranca@yahoo.com
Telephone: +39-91-6552348 Fax: +39-91-6552324
Received: May 16, 2015
Peer-review started: May 20, 2015
First decision: June 23, 2015
Revised: July 22, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: January 7, 2016
Processing time: 228 Days and 21.3 Hours
Abstract

Gadoxetic acid improves detection and characterization of focal liver lesions in cirrhotic patients and can estimate liver function in patients undergoing liver resection. The purpose of this article is to describe the optimal gadoxetic acid study protocol for the liver, the unique characteristics of gadoxetic acid, the differences between gadoxetic acid and extra-cellular gadolium chelates, and the differences in phases of enhancement between cirrhotic and normal liver using gadoxetic acid. We also discuss how to obtain and recognize an adequate hepatobiliary phase.

Keywords: Hepatobiliary contrast materials; Gadoxetic acid; Cirrhosis; Magnetic resonance imaging; Liver

Core tip: Hepatobiliary contrast materials improve detection and characterization of focal liver lesions in cirrhotic patients and can measure liver function. Familiarity with unique characteristics of gadoxetic acid is crucial to achieve an optimal magnetic resonance examination of the liver. In this review, we discuss the protocol for gadoxetic acid enhanced magnetic resonance imaging of the liver and describe differences between gadoxetic acid and extra-cellular contrast materials.