Type:
Educational Exhibit
Keywords:
Abdominal Viscera, Abdomen, Contrast agents, Liver, MR, Contrast agent-intravenous, Cirrhosis, Metastases, Neoplasia, Retrospective, Observational, Performed at one institution
Authors:
A. T. Radu1, M.-R. POGANA2, I. Turcanu3, S. Bivol1, A. Elmaleh4, M. Lewin-Zeitoun5; 1PARIS/FR, 2Strasbourg/FR, 3Bucuresti/RO, 4Villejuif/FR, 5Villejuif Cedex/FR
DOI:
10.26044/ecr2020/C-10082
Background
MRI is at the moment the most sensible and specific non-invasive diagnostic tool for liver nodules that remain undetermined after the use of an extracellular contrast agent, hepatobilliary contrast agents increase diagnostic accuracy and reduce the necessity of liver biopsies, the use of complementary diagnostic techniques and an unnecessary follow up (5-7].
Primovist and MultiHance are the two main hepatobiliary contrast agents being used today in liver imaging. Contrary to the well known Primovist, fewer studies have been reported concerning the use of MultiHance.
Its main function is to differentiate between lesions that present functioning hepatocytes from lesions with altered hepatobiliary metabolism. The mechanism depends on the uptake of the contrast agent via OATP 8 (organic-anion-transporting polypeptide), the same as the bilirubin transporter (Fig. 1). A fraction of the hepatobiliary agent is excreted by cMOAT (multispecific canalicular organic anion transporter) into the biliary canaliculi. Thus, the lesion enhancement in the hepatobiliary phase depends upon the expression and activity of such transporters. The healthy liver will appear hyper intense (evenly enhanced) as the contrast agent uptake and excretion into the biliary tree occurs progressively.