Abstract
BACKGROUND: Assessing liver function is crucial for managing chronic liver diseases. This study aimed to evaluate the efficacy of hepatocyte uptake and the longitudinal relaxation time (T1) mapping indices from gadoxetic acid-enhanced magnetic resonance imaging (MRI) for evaluating liver function and its correlation with the albumin-bilirubin (ALBI) grading system. METHODS: We retrospectively studied 183 patients who were grouped based on ALBI score: normal liver function (NLF), ALBI 1, ALBI 2, and ALBI 3. We calculated T1 indices and analyzed their correlation with ALBI grade, and differences among ALBI groups were evaluated. Receiver operating characteristic curves were used to assess the discriminative power of hepatocyte uptake and T1 indices for liver function groups, with significance set at P<0.05. RESULTS: Significant differences were observed in hepatocyte uptake and T1 indices across the NLF and ALBI groups (P<0.001). T1 value before enhancement (T1pre), T1 value after enhancement (T1post) prolonged, and rate of decrease in the T1 relaxation time (ΔT1), hepatocyte uptake rate (K(hep)) decreased with the advancement of liver function impairment, except for T1pre shortened in ALBI 3 grade. T1post (rho =0.762, P<0.001), K(hep) (rho =-0.759, P<0.001) and ΔT1 (rho =-0.673, P<0.01) showed strong correlations with ALBI grades. T1post and K(hep) were superior to T1pre and ΔT1 across all liver function groups not only in pairwise comparison but also in stratified analysis. CONCLUSIONS: K(hep) and T1post provide good diagnostic performance in distinguishing ALBI groups. T1post exhibits the highest area under the curve (AUC) when predicting lower liver function groups, whereas K(hep) excels in predicting high-grade liver function. Gadoxetic acid-enhanced MRI with T1 mapping shows potential as a tool for assessing liver function.