Preoperative Remnant Liver Function Evaluation Using a Routine Clinical Dynamic Gd-EOB-DTPA-Enhanced MRI Protocol in Patients with Hepatocellular Carcinoma

Background To investigate the clinical feasibility of preoperative routine clinical dynamic Gd-EOB-DTPA-enhanced MRI alone to predict post-hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods 116 patients with HCC who underwent liver resection in Southwest Hospital from 2014 through 2017 were selected in this retrospective cohort study. The remnant function (RF) of the liver RF UR and RF RE15 were calculated by the sum of the uptake rate (UR) or relative enhancement at 15 min (RE15) from dynamic Gd-EOB-DTPA-enhanced MR images in the remnant liver regions, and standardized by standard liver volume (SLV) to generate sRF UR (standardized RF UR ) and sRF RE15 (standardized RF RE15 ). Student’s t test or Mann–Whitney U test, logistic regression, and ROC analyses were used to test the associations of preoperative RF UR , sRF UR , RF RE15 , sRF RE15 , the remnant liver volume (RLV)/SLV, ICG retention rate at 15 min (ICG R15) and sRF ICG-K [ICG clearance rate (ICG-K) × RLV/SLV] with PHLF. Results 28 patients were found to have PHLF, who showed lower RF UR , sRF UR , RF RE15 , sRF RE15 , RLV/SLV, sRF ICG-K , and higher ICG R15 than patients without PHLF ( p