Original article—liver, pancreas, and biliary tractAssessment of Hepatic Fibrosis With Magnetic Resonance Elastography
Section snippets
Patient Population
Subjects undergoing clinical evaluation and management for chronic liver disease at the Mayo Clinic (Rochester, MN) between August 4, 2005, and March 10, 2007, were eligible for study participation. Inclusion criteria were as follows: (1) age 18 years or older, (2) percutaneous liver biopsy performed within 1 year of study enrollment (average time interval, 6.5 ± 3.9 mo; range, 0–12 mo), and/or (3) a diagnosis of compensated cirrhosis supported by liver histology or compatible clinical and
Patient and Volunteer Demographics and Diagnoses
Thirty-five volunteers (28% women; mean age, 37.2 ± 17.8 y; range, 19–82 y; mean body mass index, 23.6 ± 3.8 kg/m2; body mass index range, 17.9–34.8 kg/m2) with no history of liver disease and 50 patients (54% women; mean age, 55.3 ± 11.2 y; range, 21–76 y) with chronic liver disease consented to undergo MR elastography. Among patients, the major causes of chronic liver disease included chronic hepatitis C (33%), nonalcoholic fatty liver disease (20%), autoimmune hepatitis (7%), primary biliary
Discussion
The results of this study support the hypothesis that MR elastography is effective for distinguishing normal from fibrotic livers with a very high negative predictive value of 97%. It appears to be very good at differentiating normal from mild fibrosis (F0–2), and mild fibrosis (F0–2) from severe fibrosis (F3–4). The presence of steatosis does not appear to affect shear stiffness measurements.
Liver stiffness assessed by MR elastography was highly consistent among normal individuals with a mean
Conclusions
The detection of hepatic fibrosis by MR elastography appears safe and feasible in human subjects with chronic liver disease. Furthermore, this method is highly sensitive and specific for detecting intermediate stages of hepatic fibrosis based on the information available from this investigation. The presence of hepatic steatosis had no apparent effect on the liver stiffness measurements. Overall, these results provide continued motivation for further evaluation of hepatic MR elastography in
References (44)
- et al.
Burden of liver disease in the United States: summary of a workshop
Hepatology
(2002) - et al.
Projecting future complications of chronic hepatitis C in the United States
Liver Transpl
(2003) Nonalcoholic fatty liver disease: a review of current understanding and future impact
Clin Gastroenterol Hepatol
(2004)- et al.
[Diagnosis and quantification of hepatic fibrosis with diffusion weighted MR imaging: preliminary results]
J Radiol
(2004) - et al.
Elastic modulus measurements of human liver and correlation with pathology
Ultrasound Med Biol
(2002) - et al.
Consistency of human liver
J Surg Res
(1985) - et al.
Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C
Gastroenterology
(2005) - et al.
Transient elastography: a new noninvasive method for assessment of hepatic fibrosis
Ultrasound Med Biol
(2003) - et al.
Viscoelastic shear properties of in vivo breast lesions measured by MR elastography
Magn Reson Imaging
(2005) - et al.
Analysis of wave patterns in MR elastography of skeletal muscle using coupled harmonic oscillator simulations
Magn Reson Imaging
(2002)
Magnetic resonance elastography: non-invasive mapping of tissue elasticity
Med Image Anal
Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions
Am J Gastroenterol
A model to predict survival in patients with end-stage liver disease
Hepatology
Spatio-temporal directional filtering for improved inversion of MR elastography images
Med Image Anal
The burden of gastrointestinal and liver diseases, 2006
Am J Gastroenterol
An appraisal of the histopathological assessment of liver fibrosis
Gut
Liver biopsy
N Engl J Med
Reversal of hepatic fibrosis—fact or fantasy?
Hepatology
Magnetization transfer contrast imaging of liver cirrhosis
Hepatogastroenterology
Significance of intraoperative measurement of liver consistency prior to hepatic resection
Hepatogastroenterology
Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C
Hepatology
Increased hepatic resistance: a new target in the pharmacologic therapy of portal hypertension
J Clin Gastroenterol
Cited by (794)
Development of a suitable vibration pad for renal MR elastography
2024, Magnetic Resonance ImagingFast abdominal magnetic resonance elastography with simultaneous encoding of three-dimensional displacements
2024, Magnetic Resonance ImagingDifferentiation of bladder cancer with water flow elastography (WaFE)
2024, Journal of the Mechanical Behavior of Biomedical Materials
Supported by National Institutes of Health grant EB001981. P.J.R. and R.L.E. and their institution hold patents related to this technology and have a potential financial interest in this research.