Influence of hepatic fibrosis and inflammation: Correlation between histopathological changes and Gd-EOB-DTPA-enhanced MR imaging

Abstract

Objective To evaluate the influence of an active inflammatory process in the liver on Gd-EOB-DTPA-enhanced MR imaging in patients with different degrees of fibrosis/cirrhosis. Material and methods Overall, a number of 91 patients (61 men and 30 women; mean age 58 years) were included in this retrospective study. The inclusion criteria for this study were Gd-EOB-DTPA-enhanced MRI of the liver and histopathological evaluation of fibrotic and inflammatory changes. T1-weighted VIBE sequences of the liver with fat suppression were evaluated to determine the relative signal change (RE) between native and hepatobiliary phase (20min). In simple and multiple linear regression analyses, the influence of liver fibrosis/cirrhosis (Ishak score) and the histopathological degree of hepatitis (Modified Hepatic Activity Index, mHAI) on RE were evaluated. Results RE decreased significantly with increasing liver fibrosis/cirrhosis (p < 0.001) and inflammation (mHAI, p = 0.004). In particular, a correlation between RE and periportal or periseptal boundary zone hepatitis (moth feeding necrosis, mHAI A, p = 0.001) and portal inflammation (mHAI D, p < 0.001) was observed. In multiple linear regression analysis, both the degree of inflammation and the degree of fibrosis were significant predictors for RE (p < 0.01). Conclusion The results of this study suggest that the MR-based hepatic enhancement index RE is not only influenced by the degree of fibrosis, but also by the degree of inflammation.

Imaging-Based Staging of Hepatic Fibrosis in Patients with Hepatitis B: A Dynamic Radiomics Model Based on Gd-EOB-DTPA-Enhanced MRI

“…Thus, enhanced MRI is more reliable for staging hepatic fibrosis than diffusion-weighted MRI, besides hematologic and clinical parameters. Furthermore, previous studies demonstrated the potential of liver-specific Gd-EOB-DTPA-enhanced MRI in hepatic fibrosis assessment, in which the HBP after 20 min highly correlated with the degree of liver fibrosis [ 22 , 23 , 24 , 25 , 26 , 27 ]. In this study, we performed a systematic work on radiomics analysis based on Gd-EOB-DTPA-enhanced MRI.…”

“…NLE was calculated as the relative enhancement on the pre-contrast images using the following formula: NLE = (SI HBP − SI DYN1 )/(SI DYN1 ), where SI DYN1 and SI HBP are the mean signal intensities of the segmented liver ROI in the mask phase and HBP, respectively. NLE is actually a time-domain feature reported to be associated with the liver fibrosis grade in existing studies [ 22 , 23 , 24 , 25 ].…”

“…Moreover, the biochemical properties of Gd-EOB-DTPA provide an overall assessment of tissue perfusion in the arterial phase, while also assessing the specific accumulation in the liver hepatobiliary phase (HBP) after 20 min [ 20 , 21 ]. Studies pointed out that liver-specific Gd-EOB-DTPA-enhanced MRI had great potential to assess liver function and liver fibrosis [ 22 , 23 , 24 , 25 , 26 , 27 ].…”

FN1 mRNA expression of fibronectin 1 and distribution of fibronectin-associated leukocytes in humans with chronic diffuse liver diseases

“…Search for prognostic, diagnostic and therapeutic agents (Duval et al, 2015) continues, but always concerns the liver tissue itself, requiring the biopsy, which carries the risk of complications, such as infection and bleeding (Germani et al, 2011). Recently, scientists have agreed on the idea that non-invasive methods could be sufficiently informative (Verloh et al, 2019).…”

Quantification of liver function using gadoxetic acid-enhanced MRI

“…Second, it also reflects the total number of hepatocytes. For instance, the decreased relative liver enhancement (RLE) in fibrosis and cirrhosis results from the fibrotic replacement of some normal hepatocytes of the liver parenchyma [ 19 ]. In particular, gadoxetic acid enhancement in the hepatobiliary phase (HBP) reflects the net difference between uptake and excretory transporter activity [ 20 ].…”