Increase in left liver lobe function after preoperative right portal vein embolisation assessed with gadolinium-EOB-DTPA MRI

Eur Radiol. 2013 Sep;23(9):2555-60. doi: 10.1007/s00330-013-2859-1. Epub 2013 May 8.


Objectives: To prospectively evaluate the early development of regional liver function after right portal vein embolisation (PVE) with Gd-EOB-DTPA-enhanced MRI in patients scheduled for extended right hemihepatectomy.

Methods: Ten patients who received a PVE before an extended hemihepatectomy were examined before and 14 days after PVE using Gd-EOB-DTPA-enhanced MRI of the liver. In these sequences representative region of interest measurements were performed in the embolised right (RLL) and the non-embolised left liver lobe (LLL). The volume as well as hepatic uptake index (HUI) was calculated independently for each lobe.

Results: Relative enhancement 14 days after PVE decreased in the RLL and increased significantly in the LLL (P < 0.05). Average hepatic uptake index (HUI) for RLL was significantly lower 14 days after PVE than before PVE (P < 0.05) and significantly higher for LLL (P < 0.05).

Conclusions: A significant shift of contrast uptake from the right to the left liver lobe can be depicted as early as 14 days after right PVE by using Gd-EOB-DTPA-enhanced MRI, which could reflect the redirected portal venous blood flow and the rapid utilisation of a hepatic functional reserve.

Key points: • Preoperative portal vein embolisation (PVE) is widely performed before right-sided hepatic resection. • PVE increases intravenous contrast medium uptake in the left lobe of liver. • The hepatic uptake index for the left liver lobe increases rapidly after PVE. • Left liver lobe function increase may be visualised by Gd-EOB-DTPA-enhanced MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Flow Velocity
  • Cholangiocarcinoma / physiopathology*
  • Contrast Media / pharmacokinetics*
  • Embolization, Therapeutic / methods*
  • Female
  • Gadolinium DTPA / pharmacokinetics*
  • Hepatectomy / methods
  • Humans
  • Liver / physiopathology*
  • Liver Neoplasms / physiopathology*
  • Liver Neoplasms / secondary*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Portal Vein / pathology
  • Prospective Studies


  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA