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01-09-2013 | Hepatobiliary-Pancreas

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

Authors: Dominik Geisel, Lutz Lüdemann, Thomas Keuchel, Maciej Malinowski, Daniel Seehofer, Martin Stockmann, Bernd Hamm, Bernhard Gebauer, Timm Denecke

Published in: European Radiology | Issue 9/2013

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.

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Title: Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI
Authors: Dominik Geisel
Lutz Lüdemann
Thomas Keuchel
Maciej Malinowski
Daniel Seehofer
Martin Stockmann
Bernd Hamm
Bernhard Gebauer
Timm Denecke
Publication date: 01-09-2013
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 9/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2859-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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