Performance of native and gadoxetate-enhanced liver and spleen T mapping for noninvasive diagnosis of clinically significant portal hypertension: preliminary results.

Purpose: In this preliminary study, our aim was to assess the utility of quantitative native-T (T-pre), iron-corrected T (cT) of the liver/spleen and T mapping of the liver obtained during hepatobiliary phase (T-HBP) post-gadoxetate disodium, compared to spleen size/volume and APRI (aspartate aminotransferase-to-platelet ratio index) for noninvasive diagnosis of clinically significant portal hypertension [CSPH, defined as hepatic venous pressure gradient (HVPG) ≥ 10 mm Hg].

Methods: Forty-nine patients (M/F: 27/22, mean age 53y) with chronic liver disease, HVPG measurement and MRI were included. Breath-held T and cT measurements were obtained using an inversion recovery Look-Locker sequence and a T2* corrected modified Look-Locker sequence, respectively. Liver T-pre (n = 49), spleen T (obtained pre-contrast, n = 47), liver and spleen cT (both obtained pre-contrast, n = 30), liver T-HBP (obtained 20 min post gadoxetate disodium injection, n = 36) and liver T uptake (ΔT, n = 36) were measured. Spleen size/volume and APRI were also obtained. Spearman correlation coefficients were used to assess the correlation between each of liver/spleen T/cT parameters, spleen size/volume and APRI with HVPG. ROC analysis was performed to determine the performance of measured parameters for diagnosis of CSPH.

Results: There were 12/49 (24%) patients with CSPH. Liver T-pre (r = 0.287, p = 0.045), liver T-HBP (r = 0.543, p = 0.001), liver ΔT (r =  - 0.437, p = 0.008), spleen T (r = 0.311, p = 0.033) and APRI (r = 0.394, p = 0.005) were all significantly correlated with HVPG, while liver cT, spleen cT and spleen size/volume were not. The highest AUCs for the diagnosis of CSPH were achieved with liver T-HBP, liver ΔT and spleen T: 0.881 (95%CI 0.76-1.0, p = 0.001), 0.852 (0.72-0.98, p = 0.002) and 0.781 (0.60-0.95, p = 0.004), respectively.

Conclusion: Our preliminary results demonstrate the potential of liver T mapping obtained during HBP post gadoxetate disodium for the diagnosis of CSPH. These results require further validation.