Analysis of Hepatic Signal Intensity Characteristics in Gadoxetate disodium (Eovist) Enhanced Dynamic MRI following TIPS Creation: A Single Institution Experience

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

Isabella Amador, MS (she/her/hers)

Medical Student
University of Florida College of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

KP

Kevin Pierre, MD

Research Fellow
Department of Radiology, UF
LL

Luke Lambert, MD

PGY-3
Department of Radiology, UF
CS

Chris Sistrom, MD, MPH, PhD

Associate Professor (Emeritus)
Department of Radiology, UF
JG

Joseph Grajo, MD

Associate Professor of Abdominal Imaging
Department of Radiology, UF
RH

Robert Evans Heithaus, MD

Associate IR Division Chief and IR Research Director
Department of Radiology, UF

Disclosure(s):

Isabella Amador, MS: No financial relationships to disclose

Purpose: To evaluate liver enhancement characteristics pre- and post-TIPS placement in patients undergoing MRI with Gadoxetate disodium (Eovist)

Materials and Methods:

Retrospective review of 748 patients who received TIPS placement from 2014 to 2021 at a single institution was conducted, and 32 patients who underwent pre- and post-TIPS MRI with Eovist (Bayer Healthcare Pharmaceuticals, Whippany, NJ) were included. Pre- and post-TIPS lab values including liver function tests were recorded. Signal intensity (SI) measurements of the liver were obtained by drawing 2D ROIs in 3 separate areas of the liver (1 anterior division right lobe, 1 posterior division right lobe, and 1 in left lobe). Measurements were taken during pre-contrast as well as arterial, venous, 3-minute delayed and 20-minute delayed post-contrast sequences. Differences in liver signal intensity were analyzed and a paired t-test was performed for comparison of signal intensity changes and laboratory values.

Results: The 32 patients (19 males, 13 females) had a median age of 60 years (range: 33, 75). The median Na-MELD score was 13.5 (range: 7, 24). Alkaline phosphatase (ALK) levels significantly increased post-TIPS by 34% (p< 0.001). Hemoglobin and total bilirubin increased non-significantly by 21% (p=0.051) and 32% (p=0.0675), respectively. Platelets, AST, ALT, Albumin and Creatinine also did not show a statistically significant change. There was no significant difference in measured signal intensity of pre- and post-TIPS when averaging all 3 liver ROI measurements on arterial (p=0.47), venous (p=0.85), 3-minute delayed (p >0.99), or 20-minute equilibrium (p >0.99) sequences. Additionally, there was no significant difference when evaluating each individual region pre- and post-TIPS, or with lobar comparison (ex: right lobe SI pre- vs right lobe SI post-TIPS).

Conclusion:

No significant difference was found in liver signal intensity on any phase of imaging post Eovist (arterial, venous, 3-minute delayed, and 20-minute hepatobiliary phase), and laboratory values did not change significantly either. MRI with Eovist signal remains unchanged despite the perfusional differences to the liver with altered blood flow patterns induced by TIPS creation.