Significance of the Delayed hyperintense portal vein sign in the hepatobiliary phase MRI obtained with Gd-EOB-DTPA

Purpose: To determine the significance of the delayed hyperintense portal vein sign in Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Materials and Methods: This retrospective study was approved by the Institutional Review Board and the requirement for informed patient consent was obtained. Six-hundred and seventy patients who underwent Gd-EOB-DTPA-enhanced MRI were included in the study. Two readers who were blinded to clinical records reviewed MR images in consensus. The delayed hyperintense portal vein sign was defined if the portal vein appeared more hyperintense than surrounding liver parenchyma on the 30-minute delayed hepatobiliary phase. The frequency of the delayed hyperintense portal vein sign and the association between the sign and serum biochemical tests were assessed. Multivariate analysis was performed to identify which variables were associated with the sign. Optimal cutoff values of variables for reflecting the sign were obtained with ROC analysis. Results: The delayed hyperintense portal vein sign was observed in 13.0%. In multivariate analysis, a direct bilirubin level was associated with the delayed hyperintense portal vein sign. Optimum cutoff value for reflecting the delayed hyperintense portal vein sign was 2.18 mg/dL (sensitivity, 89%; specificity, 96%). Conclusion: The delayed hyperintense portal vein sign in Gd-EOB-DTPA-enhanced MRI can potentially be used to reflect hepatobiliary function. J. Magn. Reson. Imaging 2012;36:678685. (C) 2012 Wiley Periodicals, Inc.