Functional assessment of the liver with gadolinium-ethoxybenzyl-diethylenetriamine penta-acetate-enhanced MRI in living-donor liver transplantation

M. Ninomiya, K. Shirabe, H. Kayashima, Toru Ikegami, Akihiro Nishie, Norifumi Harimoto, Y. Yamashita, Tomoharu Yoshizumi, H. Uchiyama, Yoshihiko Maehara

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background A precise estimation of the capacity of the remnant liver following partial liver resection is important. In this study, the regional function of the liver in patients undergoing living-donor liver transplantation was evaluated by gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (EOB)-enhanced MRI, with special reference to the congested region. Methods EOB-MRI analysis was performed before hepatectomy in donors, and 7days after surgery in the donor and recipient. In the hepatocyte phase, from images obtained 15min after Primovist® injection, the signal intensity in each liver segment was measured and divided by the signal intensity of the erector spinae muscle (liver to muscle ratio, LMR) for standardization. Inter-regional differences in LMRs were analysed in donors and recipients. Results Thirty-two living donors and 31 recipients undergoing living-donor liver transplantation were enrolled. In donors, the LMRs of the remnant left lobe were almost equivalent among the liver segments. In the remnant right lobe without the middle hepatic vein, the mean(s.d.) LMR for congested segments (S5 and S8) was significantly lower than that for non-congested segments (S6 and S7): 2·60(0·52) versus 3·64(0·56) respectively (P<0·001). After surgery, values in the non-congested region were almost identical to those in the preoperative donor liver. LMR values in the left and right lobe graft were significantly lower than those in the corresponding segment before donor surgery (P<0·001). Conclusion The function of the congested region secondary to outflow obstruction in the remnant donor liver was approximately 70 per cent of that in the non-congested region. EOB-MRI is a promising tool to assess regional liver function, with good spatial resolution. Estimation of hepatic functional reserve in liver surgery

Original languageEnglish
Pages (from-to)944-951
Number of pages8
JournalBritish Journal of Surgery
Volume102
Issue number8
DOIs
Publication statusPublished - Jan 1 2015

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Rubiaceae
Living Donors
Gadolinium
Liver Transplantation
Acetates
Liver
Tissue Donors
Muscles
diethylenetriamine
ethyl-2-methylthio-4-methyl-5-pyrimidine carboxylate
S 6
Hepatic Veins
Hepatectomy
Acetic Acid
Hepatocytes

All Science Journal Classification (ASJC) codes

  • Surgery

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Functional assessment of the liver with gadolinium-ethoxybenzyl-diethylenetriamine penta-acetate-enhanced MRI in living-donor liver transplantation. / Ninomiya, M.; Shirabe, K.; Kayashima, H.; Ikegami, Toru; Nishie, Akihiro; Harimoto, Norifumi; Yamashita, Y.; Yoshizumi, Tomoharu; Uchiyama, H.; Maehara, Yoshihiko.

In: British Journal of Surgery, Vol. 102, No. 8, 01.01.2015, p. 944-951.

Research output: Contribution to journalArticle

Ninomiya, M. ; Shirabe, K. ; Kayashima, H. ; Ikegami, Toru ; Nishie, Akihiro ; Harimoto, Norifumi ; Yamashita, Y. ; Yoshizumi, Tomoharu ; Uchiyama, H. ; Maehara, Yoshihiko. / Functional assessment of the liver with gadolinium-ethoxybenzyl-diethylenetriamine penta-acetate-enhanced MRI in living-donor liver transplantation. In: British Journal of Surgery. 2015 ; Vol. 102, No. 8. pp. 944-951.
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abstract = "Background A precise estimation of the capacity of the remnant liver following partial liver resection is important. In this study, the regional function of the liver in patients undergoing living-donor liver transplantation was evaluated by gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (EOB)-enhanced MRI, with special reference to the congested region. Methods EOB-MRI analysis was performed before hepatectomy in donors, and 7days after surgery in the donor and recipient. In the hepatocyte phase, from images obtained 15min after Primovist{\circledR} injection, the signal intensity in each liver segment was measured and divided by the signal intensity of the erector spinae muscle (liver to muscle ratio, LMR) for standardization. Inter-regional differences in LMRs were analysed in donors and recipients. Results Thirty-two living donors and 31 recipients undergoing living-donor liver transplantation were enrolled. In donors, the LMRs of the remnant left lobe were almost equivalent among the liver segments. In the remnant right lobe without the middle hepatic vein, the mean(s.d.) LMR for congested segments (S5 and S8) was significantly lower than that for non-congested segments (S6 and S7): 2·60(0·52) versus 3·64(0·56) respectively (P<0·001). After surgery, values in the non-congested region were almost identical to those in the preoperative donor liver. LMR values in the left and right lobe graft were significantly lower than those in the corresponding segment before donor surgery (P<0·001). Conclusion The function of the congested region secondary to outflow obstruction in the remnant donor liver was approximately 70 per cent of that in the non-congested region. EOB-MRI is a promising tool to assess regional liver function, with good spatial resolution. Estimation of hepatic functional reserve in liver surgery",
author = "M. Ninomiya and K. Shirabe and H. Kayashima and Toru Ikegami and Akihiro Nishie and Norifumi Harimoto and Y. Yamashita and Tomoharu Yoshizumi and H. Uchiyama and Yoshihiko Maehara",
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AU - Ninomiya, M.

AU - Shirabe, K.

AU - Kayashima, H.

AU - Ikegami, Toru

AU - Nishie, Akihiro

AU - Harimoto, Norifumi

AU - Yamashita, Y.

AU - Yoshizumi, Tomoharu

AU - Uchiyama, H.

AU - Maehara, Yoshihiko

PY - 2015/1/1

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N2 - Background A precise estimation of the capacity of the remnant liver following partial liver resection is important. In this study, the regional function of the liver in patients undergoing living-donor liver transplantation was evaluated by gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (EOB)-enhanced MRI, with special reference to the congested region. Methods EOB-MRI analysis was performed before hepatectomy in donors, and 7days after surgery in the donor and recipient. In the hepatocyte phase, from images obtained 15min after Primovist® injection, the signal intensity in each liver segment was measured and divided by the signal intensity of the erector spinae muscle (liver to muscle ratio, LMR) for standardization. Inter-regional differences in LMRs were analysed in donors and recipients. Results Thirty-two living donors and 31 recipients undergoing living-donor liver transplantation were enrolled. In donors, the LMRs of the remnant left lobe were almost equivalent among the liver segments. In the remnant right lobe without the middle hepatic vein, the mean(s.d.) LMR for congested segments (S5 and S8) was significantly lower than that for non-congested segments (S6 and S7): 2·60(0·52) versus 3·64(0·56) respectively (P<0·001). After surgery, values in the non-congested region were almost identical to those in the preoperative donor liver. LMR values in the left and right lobe graft were significantly lower than those in the corresponding segment before donor surgery (P<0·001). Conclusion The function of the congested region secondary to outflow obstruction in the remnant donor liver was approximately 70 per cent of that in the non-congested region. EOB-MRI is a promising tool to assess regional liver function, with good spatial resolution. Estimation of hepatic functional reserve in liver surgery

AB - Background A precise estimation of the capacity of the remnant liver following partial liver resection is important. In this study, the regional function of the liver in patients undergoing living-donor liver transplantation was evaluated by gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (EOB)-enhanced MRI, with special reference to the congested region. Methods EOB-MRI analysis was performed before hepatectomy in donors, and 7days after surgery in the donor and recipient. In the hepatocyte phase, from images obtained 15min after Primovist® injection, the signal intensity in each liver segment was measured and divided by the signal intensity of the erector spinae muscle (liver to muscle ratio, LMR) for standardization. Inter-regional differences in LMRs were analysed in donors and recipients. Results Thirty-two living donors and 31 recipients undergoing living-donor liver transplantation were enrolled. In donors, the LMRs of the remnant left lobe were almost equivalent among the liver segments. In the remnant right lobe without the middle hepatic vein, the mean(s.d.) LMR for congested segments (S5 and S8) was significantly lower than that for non-congested segments (S6 and S7): 2·60(0·52) versus 3·64(0·56) respectively (P<0·001). After surgery, values in the non-congested region were almost identical to those in the preoperative donor liver. LMR values in the left and right lobe graft were significantly lower than those in the corresponding segment before donor surgery (P<0·001). Conclusion The function of the congested region secondary to outflow obstruction in the remnant donor liver was approximately 70 per cent of that in the non-congested region. EOB-MRI is a promising tool to assess regional liver function, with good spatial resolution. Estimation of hepatic functional reserve in liver surgery

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