Magnetic Resonance Elastography and Other Magnetic Resonance Imaging Techniques in Chronic Liver Disease: Current Status and Future Directions

Tan, Cher Heng; Venkatesh, Sudhakar K.

doi:10.5009/gnl15492

Cited by 35 publications

(19 citation statements)

References 106 publications

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“…MRE is an MRI-based method for quantitatively imaging tissue stiffness. Compared with US-based elastography techniques, MRE has advantages of larger volume coverage, higher reliable LS measurement rates [ 42 ]. However, it remains too cumbersome and not standardized enough for widespread use in routine practice.…”

Section: Discussionmentioning

confidence: 99%

Liver fibrosis detection and staging: a comparative study of T1ρ MR imaging and 2D real-time shear-wave elastography

Xinpin

Yan

et al. 2017

Abdom Radiol

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PurposeTo compare the results of T1ρ MR imaging and 2D real-time shear-wave elastography (SWE) for liver fibrosis detection and staging.MethodsTwenty-nine rabbit models of CCl4-induced liver fibrosis were established and six untreated rabbits served as controls. T1ρ MR imaging and 2D real-time SWE examination were performed at 2, 4, 6, 8, 10, and 12 weeks. T1ρ values and liver stiffness (LS) values were measured. Fibrosis was staged according to the METAVIR scoring system. Correlation test was performed among T1ρ values, LS values, and fibrosis stage. Receiver operating characteristic (ROC) analysis was performed for assessing diagnostic performance of T1ρ and SWE in detection of no fibrosis (F0), substantial fibrosis (≥ F2), severe fibrosis (≥ F3), and cirrhosis (F4).ResultsThere was moderate positive correlation between fibrosis stage and T1ρ values (r = 0.566; 95% CI 0.291–0.754; P < 0.0001), and LS value (r = 0.726; 95% CI 0.521–0.851; P = 0.003). T1ρ values showed moderate positive correlations with LS values [r = 0.693; 95% confidence interval (CI) 0.472–0.832; P < 0.0001]. Areas Under ROC (AUROCs) were 0.861 (95% CI 0.705–0.953) for SWE and 0.856 (95% CI 0.698–0.950) for T1ρ (P = 0.940), 0.906 (95% CI 0.762–0.978) for SWE and 0.849 (95% CI 0.691–0.946) for T1ρ (P = 0.414), 0.870 (95% CI 0.716–0.958) for SWE and 0.799 (95% CI 0.632–0.913) for T1ρ (P = 0.422), and 0.846 (95% CI 0.687–0.944) for SWE and 0.692 (95% CI 0.517–0.835) for T1ρ (P = 0.137), when diagnosing liver fibrosis with ≥ F1, ≥ F2, ≥ F3, and F4, respectively. There was moderate positive correlation between inflammatory activity and T1ρ values (r = 0.520; 95% CI 0.158–0.807; P = 0.013).ConclusionT1ρ imaging has potential for liver fibrosis detection and staging with good diagnostic capability similar to that of ultrasonography elastography.

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Section: Discussionmentioning

confidence: 99%

Liver fibrosis detection and staging: a comparative study of T1ρ MR imaging and 2D real-time shear-wave elastography

Xinpin

Yan

et al. 2017

Abdom Radiol

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“…Previous studies have demonstrated that MRE is a useful noninvasive technique for detecting hepatic fibrosis, and LS values can be used to grade fibrosis (131415). Lee et al (16) reported good repeatability and reproducibility of the LS measurement using MRE.…”

Section: Discussionmentioning

confidence: 99%

Segmental Liver Stiffness Evaluated with Magnetic Resonance Elastography Is Responsive to Endovascular Intervention in Patients with Budd-Chiari Syndrome

Lyu

et al. 2019

Korean J Radiol

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Objective To assess segmental liver stiffness (LS) with MRI before and after endovascular intervention in patients with Budd-Chiari syndrome (BCS). Materials and Methods Twenty-three patients (13 males and 10 females; mean age, 42.6 ± 12.6 years; age range, 31–56 years) with BCS as a primary liver disease were recruited for this study. Two consecutive magnetic resonance elastography (MRE) examinations were performed before the endovascular treatment. Fifteen patients who underwent endovascular intervention treatment also had follow-up MRE scans within three days after the procedure. LS was measured in three liver segments: the right posterior, right anterior, and left medial segments. Inter-reader and inter-exam repeatability were analyzed with intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Segmental LS and clinical characteristics before and after the intervention were also compared. Results Within three days of the endovascular intervention, all three segmental LS values decreased: LS of the right posterior segment = 7.23 ± 0.88 kPa (before) vs. 4.94 ± 0.84 kPa (after), LS of the right anterior segment = 7.30 ± 1.06 kPa (before) vs. 4.77 ± 0.85 kPa (after), and LS of the left medial segment = 7.22 ± 0.87 kPa (before) vs. 4.87 ± 0.72 kPa (after) (all p = 0.001). There was a significant correlation between LS changes and venous pressure gradient changes before and after treatments (r = 0.651, p = 0.009). The clinical manifestations of all 15 patients significantly improved after therapy. The MRE repeatability was excellent, with insignificant variations (inter-reader, ICC = 0.839–0.943: inter-examination, ICC = 0.765–0.869). Bland-Altman analysis confirmed excellent agreement (limits of agreement, 13.4–19.4%). Conclusion Segmental LS measured by MRE is a promising repeatable quantitative biomarker for monitoring the treatment response to minimally invasive endovascular intervention in patients with BCS.

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“…These technical advantages not only improve the accuracy of fat or iron quantitation but also the reproducibility of the measurements, consistent with a previous study. 35…”

Section: Discussionmentioning

confidence: 99%

Quantitative magnetic resonance imaging evaluation of hepatic fat content with iron deposition: will it be disturbed?

Wang

et al. 2019

J Int Med Res

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Objective To explore noninvasive assessment of liver fat content with iron deposition using magnetic resonance (MR) quantitative technology. Methods A water–fat phantom with iron deposition containing 63 vials with predetermined fat percentages and iron concentrations was constructed. Thirty-three patients underwent fat quantitative MR examinations. The fat fraction (FF) was determined by three Dixon techniques. Pathological evaluation findings and the steatosis area rate (SAR) were used as the gold standards. Results FFIOP and FFLAVA-Flex significantly differed from FFTEST for iron concentrations of 1 to 30 µg/mL and fat components of 10% to 80%. Using the three Dixon techniques, FFIOP was 15.76% ± 6.98%, FFLAVA-Flex was 16.71% ± 6.77%, and FFIDEAL IQ was 13.18% ± 6.42% in patients without liver cirrhosis; these values in patients with liver cirrhosis were 20.35% ± 6.11%, 20.89% ± 8.49%, and 12.86% ± 4.00%, respectively. The SAR in patients without and with liver cirrhosis was 11.31% ± 5.89% and 9.84% ± 4.17%, respectively. There were significant positive correlations between FFIDEAL IQ and SAR with or without liver cirrhosis. Conclusion Iron deposition must be considered when using quantitative MR techniques to evaluate the hepatic fat content. Compared with the IOP and LAVA-Flex techniques, the IDEAL IQ technique has more stability and accuracy in measurement of the hepatic fat content, free from iron deposition.

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Magnetic Resonance Elastography and Other Magnetic Resonance Imaging Techniques in Chronic Liver Disease: Current Status and Future Directions

Cited by 35 publications

References 106 publications

Liver fibrosis detection and staging: a comparative study of T1ρ MR imaging and 2D real-time shear-wave elastography

Liver fibrosis detection and staging: a comparative study of T1ρ MR imaging and 2D real-time shear-wave elastography

Segmental Liver Stiffness Evaluated with Magnetic Resonance Elastography Is Responsive to Endovascular Intervention in Patients with Budd-Chiari Syndrome

Quantitative magnetic resonance imaging evaluation of hepatic fat content with iron deposition: will it be disturbed?

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