PMC4900202_01
Comparison of relative amounts of hepatic delivery and bile excretion of gadoxetate disodium at 1.5 minutes (A and B) and 20 minutes (C and D) after the intravenous administration of the hepatobiliary-specific contrast agent in the child with PFIC type 1 (A and C) and a separate child with normal liver function (B and D). Signal intensities were measured by region-of-interest analysis at the aorta (arrowheads) and liver parenchyma (circles) away from any large vessels to calculate the liver-to-aorta ratio (L/R). The L/R ratio was lower in the patient with PFIC type 1 at both 1.5 and 20 minutes (L/R = 1.0 and 1.3, respectively) than the patient with normal liver function (L/R = 1.2 and 1.6, respectively). On delayed imaging, contrast excreted into the bile duct (arrow in D) in the normal patient, but not in the patient with PFIC type 1.
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Instead, more contrast material was retained in the blood pool and drained into the hepatic veins (Fig. 1A) than is typically seen in normal patients who have received gadoxetate disodium (Fig. 1B). At 20 minutes after administration of gadoxetate disodium, the liver parenchyma showed relatively little enhancement and minimal excretion into the bile ducts (Fig. 1C), compared with normal hepatobiliary phase imaging (Fig. 1D).