AI Article Synopsis
- - The study explores how liver growth behaves after a procedure called ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) by using MRI with a contrast agent (gadoxetic acid) to measure liver volume and function in Wistar rats.
- - Rats were divided into three groups: ALPPS, major liver resection (LR), and portal vein ligation (PVL), and their liver volume and function were tracked for five days post-surgery.
- - The results showed that liver function increased more than volume in the ALPPS and LR groups after the first day, with total liver function remaining well above 60% of pre-op values for ALPPS and PVL
Article Abstract
Background: This animal study investigates the hypothesis of an immature liver growth following ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) by measuring liver volume and function using gadoxetic acid avidity in magnetic resonance imaging (MRI) in models of ALPPS, major liver resection (LR) and portal vein ligation (PVL).
Methods: Wistar rats were randomly allocated to ALPPS, LR or PVL. In contrast-enhanced MRI scans with gadoxetic acid (Primovist®), liver volume and function of the right median lobe (=future liver remnant, FLR) and the deportalized lobes (DPL) were assessed until post-operative day (POD) 5. Liver function was defined as the inverse value of time from injection of gadoxetic acid to the blood pool-corrected maximum signal intensity multiplied by the volume.
Results: In ALPPS (n = 6), LR (n = 6) and PVL (n = 6), volume and function increased proportionally, except on POD 1. Thereafter, function exceeded volume increase in LR and ALPPS, but not in PVL. Total liver function was significantly reduced after LR until POD 3, but never undercuts 60% of its pre-operative value following ALPPS and PVL.
Discussion: This study shows for the first time that functional increase is proportional to volume increase in ALPPS using gadoxetic acid avidity in MRI.
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| http://dx.doi.org/10.1016/j.hpb.2023.12.007 | DOI Listing |
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