Rationale and objectives: The objective was to analyze if liver enhancement with mangafodipir trisodium was influenced by liver cirrhosis.
Methods: Eighty patients (49 with cirrhotic and 31 with noncirrhotic livers) were studied with spin-echo and spoiled gradient-echo T1-weighted images, before and after administration of mangafodipir trisodium. Hepatic insufficiency was assessed using the Child classification. Image analysis was performed both qualitatively and quantitatively.
Results: Noncirrhotic livers enhanced homogeneously but 37% of cirrhotic livers did not; the difference was significant. Areas corresponding to collapsed fibrous zones enhanced less than the rest of the parenchyma; areas of regenerating nodular zones enhanced more. Signal-to-noise ratios were significantly less for cirrhotic livers on postcontrast spoiled gradient-echo images. Cirrhotic livers had significantly lower relative enhancement ratios than noncirrhotic ones. The Child index and aspartate aminotransferase values were statistically related to the enhancement ratio.
Conclusions: Mangafodipir trisodium enhancement in cirrhotic livers is related to necrosis and regeneration of the hepatocytes. Cirrhotic livers enhanced less than noncirrhotic ones.