Skip to main content
Erschienen in: Abdominal Radiology 3/2020

01.03.2020 | Hepatobiliary

Comparison of liver stiffness measurement with MRE and liver and spleen volumetry for prediction of disease severity and hepatic decompensation in patients with primary sclerosing cholangitis

verfasst von: Ilkay S. Idilman, Hsien Min Low, Zeinab Bakhshi, John Eaton, Sudhakar K. Venkatesh

Erschienen in: Abdominal Radiology | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare liver stiffness measurement (LSM) with magnetic resonance elastography (MRE) and liver and spleen volumetry for prediction of disease severity and hepatic decompensation in primary sclerosing cholangitis (PSC).

Methods

This retrospective study was approved by the institutional review board. Magnetic resonance imaging (MRI) and MRE studies were reviewed, and mean LSM of entire liver, right lobe and left lobe, total liver, right lobe, left lobe, caudate lobe, and spleen volumes were calculated. Qualitative evaluation of lobar atrophy or hypertrophy and presence of macronodular regeneration (MNR) was recorded. Statistical analysis was performed to evaluate correlations between LSM, volumetry measurements, and Mayo risk score. Univariate and multivariate analyses were performed to predict hepatic decompensation.

Results

A total of 266 patients with PSC were included in the study. Lobar stiffness measures were higher in the presence of relative lobe atrophy. Mean LSM was higher in the presence of MNR. Significant correlations were observed between mean LSM and volumetry measurements with a fair correlation between LSM and spleen volume (rs = 0.526, p < 0.0001). Among the measurements, the best correlation was observed between mean LSM and Mayo risk score (rs = 0.646, p < 0.0001). In the multivariate analyses, mean LSM and Mayo risk score were significantly associated with liver decompensation (hazard ratio, 1.18; 95%CI 1.02–1.36 and hazard ratio, 1.65; 95%CI 1.08–2.53, respectively).

Conclusion

LSM with MRE performs significantly better than liver and spleen volumes for prediction of both disease severity and hepatic decompensation.
Literatur
1.
Zurück zum Zitat Dyson JK, Beuers U, Jones DEJ, Lohse AW, Hudson M (2018) Primary sclerosing cholangitis. Lancet 23;391:2547-2559.CrossRef Dyson JK, Beuers U, Jones DEJ, Lohse AW, Hudson M (2018) Primary sclerosing cholangitis. Lancet 23;391:2547-2559.CrossRef
2.
Zurück zum Zitat Parola M, Pinzani M (2019) Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues. Mol Aspects Med 65:37-55.CrossRef Parola M, Pinzani M (2019) Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues. Mol Aspects Med 65:37-55.CrossRef
3.
Zurück zum Zitat Scheuer PJ. Ludwig (1998) Symposium on biliary disorders—part II. Pathologic features and evolution of primary biliary cirrhosis and primary sclerosing cholangitis. Mayo Clinic Proc 73:179–183.CrossRef Scheuer PJ. Ludwig (1998) Symposium on biliary disorders—part II. Pathologic features and evolution of primary biliary cirrhosis and primary sclerosing cholangitis. Mayo Clinic Proc 73:179–183.CrossRef
4.
Zurück zum Zitat Eaton JE, Talwalkar JA, Lazaridis KN, Gores GJ, Lindor KD (2013) Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management. Gastroenterology 145:521-36.CrossRef Eaton JE, Talwalkar JA, Lazaridis KN, Gores GJ, Lindor KD (2013) Pathogenesis of primary sclerosing cholangitis and advances in diagnosis and management. Gastroenterology 145:521-36.CrossRef
5.
Zurück zum Zitat Schramm C, Eaton J, Ringe KI, Venkatesh S, Yamamura J, MRI working group of the IPSCSG (2017) MRI working group of the IPSCSG. Recommendations on the use of magnetic resonance imaging in PSC-A position statement from the International PSC Study Group. Hepatology 66:1675–88.CrossRef Schramm C, Eaton J, Ringe KI, Venkatesh S, Yamamura J, MRI working group of the IPSCSG (2017) MRI working group of the IPSCSG. Recommendations on the use of magnetic resonance imaging in PSC-A position statement from the International PSC Study Group. Hepatology 66:1675–88.CrossRef
6.
Zurück zum Zitat Kovač JD, Weber MA (2016) Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis: an Update on MR Imaging Findings with Recent Developments. J Gastrointestin Liver Dis 25:517-524.PubMed Kovač JD, Weber MA (2016) Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis: an Update on MR Imaging Findings with Recent Developments. J Gastrointestin Liver Dis 25:517-524.PubMed
7.
Zurück zum Zitat Bader TR, Beavers KL, Semelka RC (2003) MR imaging features of primary sclerosing cholangitis: patterns of cirrhosis in relationship to clinical severity of disease. Radiology 226:675-85.CrossRef Bader TR, Beavers KL, Semelka RC (2003) MR imaging features of primary sclerosing cholangitis: patterns of cirrhosis in relationship to clinical severity of disease. Radiology 226:675-85.CrossRef
8.
Zurück zum Zitat Kitzing YX, Whitley SA, Upponi SS, Srivastava B, Alexander GJ, Lomas DJ (2017) Association between progressive hepatic morphology changes on serial MR imaging and clinical outcome in primary sclerosing cholangitis. J Med Imaging Radiat Oncol 61:636-642.CrossRef Kitzing YX, Whitley SA, Upponi SS, Srivastava B, Alexander GJ, Lomas DJ (2017) Association between progressive hepatic morphology changes on serial MR imaging and clinical outcome in primary sclerosing cholangitis. J Med Imaging Radiat Oncol 61:636-642.CrossRef
9.
Zurück zum Zitat Khoshpouri P, Ameli S, Ghasabeh MA, Pandey A, Zarghampour M, Varzaneh FN, Jacob A, Pandey P, Luo Y, Kamel IR (2018) Correlation between quantitative liver and spleen volumes and disease severity in primary sclerosing cholangitis as determined by Mayo risk score. Eur J Radiol 108:254-260.CrossRef Khoshpouri P, Ameli S, Ghasabeh MA, Pandey A, Zarghampour M, Varzaneh FN, Jacob A, Pandey P, Luo Y, Kamel IR (2018) Correlation between quantitative liver and spleen volumes and disease severity in primary sclerosing cholangitis as determined by Mayo risk score. Eur J Radiol 108:254-260.CrossRef
10.
Zurück zum Zitat Khoshpouri P, Hazhirkarzar B, Ameli S, Pandey A, Ghadimi M, Rezvani Habibabadi R, Aliyari Ghasabeh M, Pandey P, Shaghaghi M, Kamel IR (2019) Quantitative spleen and liver volume changes predict survival of patients with primary sclerosing cholangitis. Clin Radiol 74:734.e13-734.e20.CrossRef Khoshpouri P, Hazhirkarzar B, Ameli S, Pandey A, Ghadimi M, Rezvani Habibabadi R, Aliyari Ghasabeh M, Pandey P, Shaghaghi M, Kamel IR (2019) Quantitative spleen and liver volume changes predict survival of patients with primary sclerosing cholangitis. Clin Radiol 74:734.e13-734.e20.CrossRef
11.
Zurück zum Zitat Jhaveri KS, Hosseini-Nik H, Sadoughi N, Janssen H, Feld JJ, Fischer S, Menezes R, Cheung AC (2019) The development and validation of magnetic resonance elastography for fibrosis staging in primary sclerosing cholangitis. Eur Radiol 29:1039-1047.CrossRef Jhaveri KS, Hosseini-Nik H, Sadoughi N, Janssen H, Feld JJ, Fischer S, Menezes R, Cheung AC (2019) The development and validation of magnetic resonance elastography for fibrosis staging in primary sclerosing cholangitis. Eur Radiol 29:1039-1047.CrossRef
12.
Zurück zum Zitat Eaton JE, Dzyubak B, Venkatesh SK, Smyrk TC, Gores GJ, Ehman RL, LaRusso NF, Gossard AA, Lazaridis KN (2016) Performance of magnetic resonance elastography in primary sclerosing cholangitis. J Gastroenterol Hepatol 31:1184-90.CrossRef Eaton JE, Dzyubak B, Venkatesh SK, Smyrk TC, Gores GJ, Ehman RL, LaRusso NF, Gossard AA, Lazaridis KN (2016) Performance of magnetic resonance elastography in primary sclerosing cholangitis. J Gastroenterol Hepatol 31:1184-90.CrossRef
13.
Zurück zum Zitat Bookwalter CA, Venkatesh SK, Eaton JE, Smyrk TD, Ehman RL (2018) MR elastography in primary sclerosing cholangitis: correlating liver stiffness with bile duct strictures and parenchymal changes. Abdom Radiol 43:3260-3270.CrossRef Bookwalter CA, Venkatesh SK, Eaton JE, Smyrk TD, Ehman RL (2018) MR elastography in primary sclerosing cholangitis: correlating liver stiffness with bile duct strictures and parenchymal changes. Abdom Radiol 43:3260-3270.CrossRef
14.
Zurück zum Zitat Kim WR, Therneau TM, Wiesner RH, Poterucha JJ, Benson JT, Malinchoc M, LaRusso NF, Lindor KD, Dickson ER (2000) A revised natural history model for primary sclerosing cholangitis. Mayo Clin Proc 75:688-94.CrossRef Kim WR, Therneau TM, Wiesner RH, Poterucha JJ, Benson JT, Malinchoc M, LaRusso NF, Lindor KD, Dickson ER (2000) A revised natural history model for primary sclerosing cholangitis. Mayo Clin Proc 75:688-94.CrossRef
15.
Zurück zum Zitat Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D’Amico G, Dickson ER, Kim WR (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33:464-70.CrossRef Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D’Amico G, Dickson ER, Kim WR (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33:464-70.CrossRef
16.
Zurück zum Zitat Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544-55.CrossRef Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544-55.CrossRef
17.
Zurück zum Zitat Dzyubak B, Venkatesh SK, Manduca A, Glaser KJ, Ehman RL (2016) Automated liver elasticity calculation for MR elastography. J Magn Reson Imaging 43:1055-63.CrossRef Dzyubak B, Venkatesh SK, Manduca A, Glaser KJ, Ehman RL (2016) Automated liver elasticity calculation for MR elastography. J Magn Reson Imaging 43:1055-63.CrossRef
18.
Zurück zum Zitat Aubé C (2015) Imaging modalities for the diagnosis of hepatic fibrosis and cirrhosis. Clin Res Hepatol Gastroenterol 39:38-44.CrossRef Aubé C (2015) Imaging modalities for the diagnosis of hepatic fibrosis and cirrhosis. Clin Res Hepatol Gastroenterol 39:38-44.CrossRef
19.
Zurück zum Zitat Ehlken H, Wroblewski R, Corpechot C, Arrivé L, Rieger T, Hartl J, Lezius S, Hübener P, Schulze K, Zenouzi R, Sebode M, Peiseler M, Denzer UW, Quaas A, Weiler-Normann C, Lohse AW, Chazouilleres O, Schramm C (2016) Validation of Transient Elastography and Comparison with Spleen Length Measurement for Staging of Fibrosis and Clinical Prognosis in Primary Sclerosing Cholangitis. PLoS One 10;11(10):e0164224.CrossRef Ehlken H, Wroblewski R, Corpechot C, Arrivé L, Rieger T, Hartl J, Lezius S, Hübener P, Schulze K, Zenouzi R, Sebode M, Peiseler M, Denzer UW, Quaas A, Weiler-Normann C, Lohse AW, Chazouilleres O, Schramm C (2016) Validation of Transient Elastography and Comparison with Spleen Length Measurement for Staging of Fibrosis and Clinical Prognosis in Primary Sclerosing Cholangitis. PLoS One 10;11(10):e0164224.CrossRef
20.
Zurück zum Zitat Jung F, Cazzagon N, Vettorazzi E, Corpechot C, Chazouilleres O, Arrivé L, Lohse AW, Schramm C, Ehlken H (2019) Rate of Spleen Length Progression Is a Marker of Outcome in Patients With Primary Sclerosing Cholangitis. Clin Gastroenterol Hepatol. Jan 4. pii: S1542-3565(19)30006-0. https://doi.org/10.1016/j.cgh.2018.12.033. [Epub ahead of print]CrossRef Jung F, Cazzagon N, Vettorazzi E, Corpechot C, Chazouilleres O, Arrivé L, Lohse AW, Schramm C, Ehlken H (2019) Rate of Spleen Length Progression Is a Marker of Outcome in Patients With Primary Sclerosing Cholangitis. Clin Gastroenterol Hepatol. Jan 4. pii: S1542-3565(19)30006-0. https://​doi.​org/​10.​1016/​j.​cgh.​2018.​12.​033. [Epub ahead of print]CrossRef
21.
Zurück zum Zitat Corpechot C, Gaouar F, El Naggar A, Kemgang A, Wendum D, Poupon R, Carrat F, Chazouillères O (2014) Baseline values and changes in liver stiffness measured by transient elastography are associated with severity of fibrosis and outcomes of patients with primary sclerosing cholangitis. Gastroenterology. 146:970-9.CrossRef Corpechot C, Gaouar F, El Naggar A, Kemgang A, Wendum D, Poupon R, Carrat F, Chazouillères O (2014) Baseline values and changes in liver stiffness measured by transient elastography are associated with severity of fibrosis and outcomes of patients with primary sclerosing cholangitis. Gastroenterology. 146:970-9.CrossRef
22.
Zurück zum Zitat Lee DH, Lee JM, Chang W, Yoon JH, Kim YJ, Lee JH, Yu SJ, Han JK (2018) Prognostic Role of Liver Stiffness Measurements Using Magnetic Resonance Elastography in Patients with Compensated Chronic Liver Disease. Eur Radiol. 28:3513-3521.CrossRef Lee DH, Lee JM, Chang W, Yoon JH, Kim YJ, Lee JH, Yu SJ, Han JK (2018) Prognostic Role of Liver Stiffness Measurements Using Magnetic Resonance Elastography in Patients with Compensated Chronic Liver Disease. Eur Radiol. 28:3513-3521.CrossRef
Metadaten
Titel
Comparison of liver stiffness measurement with MRE and liver and spleen volumetry for prediction of disease severity and hepatic decompensation in patients with primary sclerosing cholangitis
verfasst von
Ilkay S. Idilman
Hsien Min Low
Zeinab Bakhshi
John Eaton
Sudhakar K. Venkatesh
Publikationsdatum
01.03.2020
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 3/2020
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-019-02387-4

Weitere Artikel der Ausgabe 3/2020

Abdominal Radiology 3/2020 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.