Noninvasive Monitoring of Liver Disease Regression after Hepatitis C Eradication Using Gadoxetic Acid-Enhanced MRI

摘要

We evaluated changes in relative liver enhancement (RLE) obtained by gadoxetic acid-enhanced MRI (GA-MRI) in the hepatobiliary phase and changes in splenic volume (SV) after hepatitis C virus (HCV) eradication as well as their predictive value for the development of (further) hepatic decompensation during follow-up. This retrospective study comprised 31 consecutive patients with HCV-induced advanced chronic liver disease who underwent GA-MRI before and after successful interferon-free treatment, as well as a cohort of 14 untreated chronic HCV-patients with paired GA-MRI. RLE increased by 66% (20%–94%; ) from pre- to posttreatment, while SV decreased by ?16% (?28% to ?8%; ). However, SV increased in 16% (5/31) of patients, the identical subjects who showed a decrease in RLE (GA-MRI-nonresponse). We observed an inverse correlation between the changes in RLE and SV (). In the untreated patients, there was a decrease in RLE by ?11% (?25% to ?3%; ) and an increase in SV by 23% (7%–43%; ) (both versus treated patients). Interestingly, GA-MRI-nonresponse was associated with a substantially increased risk of (further) hepatic decompensation 2 years after the end of treatment 80% versus 8%; . GA-MRI might distinguish between individuals at low and high risk of (further) hepatic decompensation (GA-MRI-nonresponse) after HCV eradication. This could allow for individualized surveillance strategies.