Gadoxetate disodium in patients with primary sclerosing cholangitis: an analysis of hepatobiliary contrast excretion

PURPOSE

To assess hepatobiliary excretion of gadoxetate disodium in patients with primary sclerosing cholangitis (PSC) over time and to determine a possible correlation with severity of the disease.

MATERIALS AND METHODS

A total of 111 patients (36 females, 75 males, mean age 41.5 yr) with confirmed diagnosis of PSC who underwent gadoxetate disodium enhanced hepatic MRI were included in this retrospective institutional review board-approved study. Hepatocyte phase images (10-493 min post injection [p.i.]) were evaluated by one radiologist for the presence of contrast agent in the intrahepatic bile ducts (IBD), common bile duct (CBD), gallbladder (GB), and duodenum. In 54 patients, in whom hepatocyte phase scans were acquired within 10-20 min p.i., hepatobiliary excretion was compared with data collected in a previous study from patients without liver disease (controls; Mann-Whitney U-test). Excretion was further correlated with liver function tests (Kruskal-Wallis test).

RESULTS

Compared with controls, excretion was significantly delayed in patients with PSC: 20 min p.i. gadoxetate disodium could be detected in the IBD in 55.6% (controls:100%), CBD 53.7% (controls:100%), GB 39.6% (controls:87%), duodenum 13% (controls:66%), respectively. Contrast appearance in different bile duct sections increased over time and correlated significantly with serum bilirubin and AP levels (P < 0.05).

CONCLUSION

Hepatobiliary excretion of gadoxetate disodium in PSC patients is significantly delayed. Excretion correlates with bilirubin levels, and thus indirectly with severity of disease.