scholarly journals Non-invasive assessment of liver fibrosis in autoimmune hepatitis: Diagnostic value of liver magnetic resonance parametric mapping including extracellular volume fraction

2020 ◽  
Author(s):  
Narine Mesropyan ◽  
Patrick Kupczyk ◽  
Leona Dold ◽  
Tobias J. Weismüller ◽  
Alois M. Sprinkart ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Liver Stiffness ◽  
Extracellular Volume Fraction ◽  
Diagnostic Value ◽  
Parametric Mapping ◽  
Significant Fibrosis ◽  
Non Invasive ◽  
Mapping Parameters

Abstract Purpose Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that leads to severe fibrosis and cirrhosis. The aim of this study was to determine the diagnostic value of T1 and T2 mapping as well as extracellular volume fraction (ECV) for non-invasive assessment of liver fibrosis in AIH patients. Methods In this prospective study, 27 patients (age range: 19–77 years) with AIH underwent liver MRI. T1 and T2 relaxation times as well as ECV were quantified by mapping techniques. The presence of significant fibrosis (≥ F2) was defined as magnetic resonance elastography (MRE)-based liver stiffness ≥ 3.66 kPa. MRE was used as reference standard, against which the diagnostic performance of MRI-derived mapping parameters was tested. Diagnostic performance was compared by utilizing receiver-operating characteristic (ROC) analysis. Results MRE-based liver stiffness correlated with both, hepatic native T1 (r = 0.69; P < 0.001) as well as ECV (r = 0.80; P < 0.001). For the assessment of significant fibrosis, ECV yielded a sensitivity of 85.7% (95% confidence interval (CI): 60.1–96.0%) and a specificity of 84.6% (CI 60.1–96.0%); hepatic native T1 yielded a sensitivity of 85.7% (CI 60.1–96.0%); and a specificity of 76.9% (CI 49.7–91.8%). Diagnostic performance of hepatic ECV (area under the curve (AUC): 0.885), native hepatic T1 (AUC: 0.846) for assessment of significant fibrosis was similar compared to clinical fibrosis scores (APRI (AUC: 0.852), FIB-4 (AUC: 0.758), and AAR (0.654) (P > 0.05 for each comparison)). Conclusion Quantitative mapping parameters such as T1 and ECV can identify significant fibrosis in AIH patients. Future studies are needed to explore the value of parametric mapping for the evaluation of different disease stages.

scholarly journals Diagnostic value of magnetic resonance parametric mapping for non-invasive assessment of liver fibrosis in patients with primary sclerosing cholangitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Narine Mesropyan ◽  
Patrick Kupczyk ◽  
Guido M. Kukuk ◽  
Leona Dold ◽  
Tobias Weismueller ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Diagnostic Performance ◽  
T2 Mapping ◽  
Liver Stiffness ◽  
Significant Fibrosis ◽  
Non Invasive ◽  
Native T1 ◽  
Mapping Parameters

Abstract Background Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease, characterized by bile duct inflammation and destruction, leading to biliary fibrosis and cirrhosis. The purpose of this study was to investigate the utility of T1 and T2 mapping parameters, including extracellular volume fraction (ECV) for non-invasive assessment of fibrosis severity in patients with PSC. Methods In this prospective study, patients with PSC diagnosis were consecutively enrolled from January 2019 to July 2020 and underwent liver MRI. Besides morphological sequences, MR elastography (MRE), and T1 and T2 mapping were performed. ECV was calculated from T1 relaxation times. The presence of significant fibrosis (≥ F2) was defined as MRE-derived liver stiffness ≥ 3.66 kPa and used as the reference standard, against which the diagnostic performance of MRI mapping parameters was tested. Student t test, ROC analysis and Pearson correlation were used for statistical analysis. Results 32 patients with PSC (age range 19–77 years) were analyzed. Both, hepatic native T1 (r = 0.66; P < 0.001) and ECV (r = 0.69; P < 0.001) correlated with MRE-derived liver stiffness. To diagnose significant fibrosis (≥ F2), ECV revealed a sensitivity of 84.2% (95% confidence interval (CI) 62.4–94.5%) and a specificity of 84.6% (CI 57.8–95.7%); hepatic native T1 revealed a sensitivity of 52.6% (CI 31.7–72.7%) and a specificity of 100.0% (CI 77.2–100.0%). Hepatic ECV (area under the curve (AUC) 0.858) and native T1 (AUC 0.711) had an equal or higher diagnostic performance for the assessment of significant fibrosis compared to serologic fibrosis scores (APRI (AUC 0.787), FIB-4 (AUC 0.588), AAR (0.570)). Conclusions Hepatic T1 and ECV can diagnose significant fibrosis in patients with PSC. Quantitative mapping has the potential to be a new non-invasive biomarker for liver fibrosis assessment and quantification in PSC patients.

SAT-423-Spleen extracellular volume fraction and platelet count/spleen volume ratio are accurate non-invasive markers of portal hypertension

2019 ◽  
Vol 70 (1) ◽  
pp. e820-e821
Author(s):  
Christina Levick ◽  
Michael Pavlides ◽  
DavidJ Breen ◽  
Kathryn Nash ◽  
Gideon Hirschfield ◽  
...  
Keyword(s):  
Platelet Count ◽  
Portal Hypertension ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Volume Ratio ◽  
Extracellular Volume Fraction ◽  
Spleen Volume ◽  
Non Invasive

Quantitative liver MRI including extracellular volume fraction for non-invasive quantification of liver fibrosis: a prospective proof-of-concept study

Gut ◽  
2017 ◽  
Vol 67 (3) ◽  
pp. 593-594 ◽  
Author(s):  
Julian A Luetkens ◽  
Sabine Klein ◽  
Frank Traeber ◽  
Frederic C Schmeel ◽  
Alois M Sprinkart ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Proof Of Concept ◽  
Liver Mri ◽  
Concept Study ◽  
Non Invasive

scholarly journals Magnetic resonance parametric mapping of the spleen for non-invasive assessment of portal hypertension

2020 ◽  
Vol 31 (1) ◽  
pp. 85-93
Author(s):  
Narine Mesropyan ◽  
Alexander Isaak ◽  
Anton Faron ◽  
Michael Praktiknjo ◽  
Christian Jansen ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Diagnostic Performance ◽  
Volume Fraction ◽  
Portal Pressure ◽  
Extracellular Volume ◽  
Relaxation Times ◽  
Pressure Measurements ◽  
Non Invasive ◽  
T1 And T2

Abstract Objectives In patients with advanced liver disease, portal hypertension is an important risk factor, leading to complications such as esophageal variceal bleeding, ascites, and hepatic encephalopathy. This study aimed to determine the diagnostic value of T1 and T2 mapping and extracellular volume fraction (ECV) for the non-invasive assessment of portal hypertension. Methods In this prospective study, 50 participants (33 patients with indication for trans-jugular intrahepatic portosystemic shunt (TIPS) and 17 healthy volunteers) underwent MRI. The derivation and validation cohorts included 40 and 10 participants, respectively. T1 and T2 relaxation times and ECV of the liver and the spleen were assessed using quantitative mapping techniques. Direct hepatic venous pressure gradient (HVPG) and portal pressure measurements were performed during TIPS procedure. ROC analysis was performed to compare diagnostic performance. Results Splenic ECV correlated with portal pressure (r = 0.72; p < 0.001) and direct HVPG (r = 0.50; p = 0.003). No significant correlations were found between native splenic T1 and T2 relaxation times with portal pressure measurements (p > 0.05, respectively). In the derivation cohort, splenic ECV revealed a perfect diagnostic performance with an AUC of 1.000 for the identification of clinically significant portal hypertension (direct HVPG ≥ 10 mmHg) and outperformed other parameters: hepatic T2 (AUC, 0.731), splenic T2 (AUC, 0.736), and splenic native T1 (AUC, 0.806) (p < 0.05, respectively). The diagnostic performance of mapping parameters was comparable in the validation cohort. Conclusion Splenic ECV was associated with portal pressure measurements in patients with advanced liver disease. Future studies should explore the diagnostic value of parametric mapping accross a broader range of pressure values. Key Points • Non-invasive assessment and monitoring of portal hypertension is an area of unmet interest. • Splenic extracellular volume fraction is strongly associated with portal pressure in patients with end-stage liver disease. • Quantitative splenic and hepatic MRI-derived parameters have a potential to become a new non-invasive diagnostic parameter to assess and monitor portal pressure.

scholarly journals Synthetic extracellular volume fraction without hematocrit sampling for hepatic applications

2021 ◽  
Author(s):  
Narine Mesropyan ◽  
Patrick Kupczyk ◽  
Alexander Isaak ◽  
Christoph Endler ◽  
Anton Faron ◽  
...  
Keyword(s):  
Volume Fraction ◽  
Pearson Correlation ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Radiology Department ◽  
Clinical Implementation ◽  
Derivation Cohort ◽  
Non Invasive ◽  
Potential Biomarker ◽  
Before And After

Abstract Purpose Calculation of extracellular volume fraction (ECV) currently receives increasing interest as a potential biomarker for non-invasive assessment of liver fibrosis. ECV calculation requires hematocrit (Hct) sampling, which might be difficult to obtain in a high-throughput radiology department. The aim of this study was to generate synthetic ECV for hepatic applications without the need for Hct sampling. Methods In this prospective study participants underwent liver MRI. T1 mapping was performed before and after contrast administration. Blood Hct was obtained prior to MRI. We hypothesized that the relationship between Hct and longitudinal relaxation rate of blood (R1 = 1/T1blood) could be calibrated and used to generate the equation for synthetic Htc and ECV calculation. Conventional and synthetic ECV were calculated. Pearson correlation, linear regression and Bland–Altman method were used for statistical analysis. Results 180 consecutive patients were divided into derivation (n = 90) and validation (n = 90) cohorts. In the derivation cohort, native R1blood and Hct showed a linear relationship (HctMOLLI = 98.04 × (1/T1blood) − 33.17, R2 = 0.75, P < 0.001), which was used to calculate synthetic ECV in the validation and whole study cohorts. Synthetic and conventional ECV showed significant correlations in the derivation, validation and in the whole study cohorts (r = 0.99, 0.97 and 0.99, respectively, P < 0.001, respectively) with minimal bias according to the Bland–Altman analysis. Conclusion Synthetic ECV seems to offer an alternative method for non-invasive quantification of the hepatic ECV. It may potentially overcome an important barrier to clinical implementation of ECV and thus, enable broader use of hepatic ECV in routine clinical practice.

scholarly journals Hepatic magnetic resonance T1-mapping and extracellular volume fraction compared to shear-wave elastography in pediatric Fontan-associated liver disease

2020 ◽  
Author(s):  
Charlotte de Lange ◽  
Karl Julius Thrane ◽  
Kristian S. Thomassen ◽  
Oliver Geier ◽  
Bac Nguyen ◽  
...  
Keyword(s):  
Shear Wave ◽  
Hepatic Fibrosis ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Extracellular Volume Fraction ◽  
Fontan Circulation ◽  
Native T1 ◽  
Mr Relaxometry

Abstract Background Children with Fontan circulation are at risk of developing hepatic fibrosis/cirrhosis. Reliable noninvasive monitoring techniques are lacking or under development. Objective To investigate surrogate indicators of hepatic fibrosis in adolescents with Fontan circulation by evaluating hepatic magnetic resonance (MR) T1 mapping and extracellular volume fraction measurements compared to US shear-wave elastography. Materials and methods We analyzed hepatic native T1 times and extracellular volume fractions with modified Look-Locker inversion recovery. Liver stiffness was analyzed with shear-wave elastography. We compared results between 45 pediatric patients ages 16.7±0.6 years with Fontan circulation and 15 healthy controls ages 19.2±1.2 years. Measurements were correlated to clinical and hemodynamic data from cardiac catheterization. Results MR mapping was successful in 35/45 patients, revealing higher hepatic T1 times (774±44 ms) than in controls (632±52 ms; P<0.001) and higher extracellular volume fractions (47.4±5.0%) than in controls (34.6±3.8%; P<0.001). Liver stiffness was 1.91±0.13 m/s in patients vs. 1.20±0.10 m/s in controls (P<0.001). Native T1 times correlated with central venous pressures (r=0.5, P=0.007). Native T1 was not correlated with elastography in patients (r=0.2, P=0.1) or controls (r = −0.3, P=0.3). Extracellular volume fraction was correlated with elastography in patients (r=0.5, P=0.005) but not in controls (r=0.2, P=0.6). Conclusion Increased hepatic MR relaxometry and shear-wave elastography values in adolescents with Fontan circulation suggested the presence of hepatic fibrosis or congestion. Central venous pressure was related to T1 times. Changes were detected differently with MR relaxometry and elastography; thus, these techniques should not be used interchangeably in monitoring hepatic fibrosis.

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