2017; 02(05): 096-103 gah/17/1720/gmj

Original Research Article

Gadoxetate-Enhanced Magnetic Resonance Cholangiography for Prognostic Purposes in Primary Sclerosing Cholangitis

Franceschet I1, Motta R1, Mantovan A1, Cazzagon N1, Buja A1, Miotto D1, Floreani A1
1Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
2Department of Medicine, University of Padova, Italy

3Department of Molecular Medicine, Laboratory of Public Health and Population Studies, University of Padova, Italy

Correspondence to
Franceschet I, Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy

First Published Online 29 June 2017

ABSTRACT

Aim: To assess the prognostic role of MRC in the follow-up of patients with primary sclerosing cholangitis (PSC). Methods: The study included 52 consecutive PSC patients who underwent MRC with Gd-EOB-DTPA at the baseline and at every 2-year follow-up. The prognostic value of the MRC was assessed using an adaptation of the original Amsterdam classification validated for endoscopic retrograde cholangiography. Images were scored from I to V, based on the severity of biliary strictures and dilations. Results: The mean follow-up was 122.3±8.7 months, and a total of 89 MRC was collected. Twenty-three patients (44.2%) had a final MRC score ≤III, while for 29 (55.8%) it was >III. Patients with MRC scores >III had significantly higher alkaline phosphatase levels, more severe liver stiffness, a higher rate of biliary complications in the baseline than patients with MRC scores ≤III. At 2-year follow-up, MRC scores >III correlated significantly with serum transaminases, GGT, and alkaline phosphatase levels. Multivariate analysis showed that the occurrence of biliary complications and the indication for a liver transplant were significantly associated with a final MRC score >III. Conclusions: MRC scores based on image features and contrast enhancement pattern after Gd-EOB-DTPA administration can provide prognostic information in PSC.

Keywords:Primary sclerosing cholangitis, magnetic resonance cholangiography, gadoxetate disodium, prognostic score, liver transplantation

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