The Effect of Gd-EOB-DPTA on the Stiffness Value of Magnetic Resonance Elastography in Evaluating Hepatic Fibrosis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose : To evaluate the effect of gadoxetic acid on the measurement of the stiffness value of MR elastography (MRE)used to evaluate hepatic fibrosis (HF). Materials and Methods: MRE was obtained in 32 patients with clinically suspected chronic liver disease, both before and after injection of gadoxetic acid. Two independent reviewers measured the stiffness values of the liver parenchyma on elastograms. The mean liver stiffness values were compared in the pre- and post-contrast MREs using the paired t-test. Intra-rater and inter-rater correlation was assessed using the intraclass correlation coefficient (ICC). The accuracy, sensitivity,and specificity of both pre- and post-contrast MREs was evaluated for the diagnosis of significant HF ( F2) using cut off value of 3.1 kPa. Results: There were no significant differences in the stiffness values of the liver parenchyma on pre- and post-contrast MREs (p = 0.15 and 0.38 for each reader, respectively). Regarding intra-rater correlation, excellent agreement was noted on rater 1(ICC = 0.998) and rater 2 (ICC = 0.996). Excellent correlation regarding the measured stiffness values was noted on both pre- and post-contrast MREs (ICC = 0.988 for pre-contrast, ICC = 0.993 for post-contrast). The accuracy, sensitivity,and specificity of the pre- and post-contrast MREs for differentiating significant HF ( F2) from F1were same as 71%, 60%, and 100%, respectively. Conclusion: As there was no significant difference in the stiffness measurements seen on MREs before and after administration of gadoxetic acids, it is therefore acceptable to perform MRE after contrast injection in order to evaluate HF.
Abstract
Purpose : To evaluate the effect of gadoxetic acid on the measurement of the stiffness value of MR elastography (MRE)used to evaluate hepatic fibrosis (HF). Materials and Methods: MRE was obtained in 32 patients with clinically suspected chronic liver disease, both before and after injection of gadoxetic acid. Two independent reviewers measured the stiffness values of the liver parenchyma on elastograms. The mean liver stiffness values were compared in the pre- and post-contrast MREs using the paired t-test. Intra-rater and inter-rater correlation was assessed using the intraclass correlation coefficient (ICC). The accuracy, sensitivity,and specificity of both pre- and post-contrast MREs was evaluated for the diagnosis of significant HF ( F2) using cut off value of 3.1 kPa. Results: There were no significant differences in the stiffness values of the liver parenchyma on pre- and post-contrast MREs (p = 0.15 and 0.38 for each reader, respectively). Regarding intra-rater correlation, excellent agreement was noted on rater 1(ICC = 0.998) and rater 2 (ICC = 0.996). Excellent correlation regarding the measured stiffness values was noted on both pre- and post-contrast MREs (ICC = 0.988 for pre-contrast, ICC = 0.993 for post-contrast). The accuracy, sensitivity,and specificity of the pre- and post-contrast MREs for differentiating significant HF ( F2) from F1were same as 71%, 60%, and 100%, respectively. Conclusion: As there was no significant difference in the stiffness measurements seen on MREs before and after administration of gadoxetic acids, it is therefore acceptable to perform MRE after contrast injection in order to evaluate HF.
참고문헌 (39)
- Taouli B, "Advanced MRI methods for assessment of chronic liver disease", AJR Am J Roentgenol, 193, pp.14~27 (2009)
- Poynard T, "Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups", Lancet, 349, pp.825~832 (1997)
- Han KH, "New diagnostic method for liver fibrosis and cirrhosis", Intervirology, 51(Suppl 1), pp.11~16 (2008)
- Bravo AA, "Liver biopsy", N Engl J Med, 344, pp.495~500 (2001)
- Regev A, "Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection", Am J Gastroenterol, 97, pp.2614~2618 (2002)
- Annet L, "Assessment of diffusion-weighted MR imaging in liver fibrosis", J Magn Reson Imaging, 25, pp.122~128 (2007)
- Huwart L, "Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index", Radiology, 245, pp.458~466 (2007)
- Fraquelli M, "Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease", Gut, 56, pp.968~973 (2007)
- Rouviere O, "MR elastography of the liver: preliminary results", Radiology, 240, pp.440~448 (2006)
- Wang Y, "Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusion-weighted imaging", AJR Am J Roentgenol, 196, pp.553~561 (2011)
- Huwart L, "Magnetic resonance elastography for the noninvasive staging of liver fibrosis", Gastroenterology, 135, pp.32~40 (2008)
- 이정민, "Consensus Report of the 4th International Forum for Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid Magnetic Resonance Imaging", Korean Journal of Radiology, 12(4), pp.403~415 (2011), 대한영상의학회
- Watanabe H, "Staging hepatic fibrosis: comparison of gadoxetate disodium-enhanced and diffusion-weighted MR imaging--preliminary observations", Radiology, 259, pp.142~150 (2011)
- Landis JR, "The measurement of observer agreement for categorical data", Biometrics, 33, pp.159~174 (1977)
- Vogl TJ, "Liver tumors: comparison of MR imaging with Gd-EOB-DTPA and Gd-DTPA", Radiology, 200, pp.59~67 (1996)
- Saito K, "Effect of Gd-EOB-DTPA on T2- weighted and diffusion-weighted images for the diagnosis of hepatocellular carcinoma", J Magn Reson Imaging, 32, pp.229~234 (2010)
- Kim KA, "Optimal T2-weighted MR cholangiopancreatographic images can be obtained after administration of gadoxetic acid", Radiology, 256, pp.475~484 (2010)
- Brown MA, "MRI Basic Princples and Applications" (2003), Wiley-Liss
- Motosugi U, "Effects of gadoxetic acid on liver elasticity measurement by using magnetic resonance elastography", Magn Reson Imaging, 30, pp.128~132 (2012)
- "Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. The French METAVIR Cooperative Study Group", Hepatology, 20, pp.15~20 (1994)
- Bedossa P, "An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group", Hepatology, 24, pp.289~293 (1996)
- Venkatesh SK, "MR elastography of liver tumors: preliminary results", AJR Am J Roentgenol, 190, pp.1534~1540 (2008)
- Manduca A, "Magnetic resonance elastography: non-invasive mapping of tissue elasticity", Med Image Anal, 5, pp.237~254 (2001)
- Hines CD, "Repeatability of magnetic resonance elastography for quantification of hepatic stiffness", J Magn Reson Imaging, 31, pp.725~731 (2010)
- Motosugi U, "Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability", Jpn J Radiol, 28, pp.623~627 (2010)
- Sun HY, "Gadoxetic acid-enhanced magnetic resonance imaging for differentiating small hepatocellular carcinomas (< or =2 cm in diameter) from arterial enhancing pseudolesions: special emphasis on hepatobiliary phase imaging", Invest Radiol, 45, pp.96~103 (2010)
- Kim YK, "Detection of small hepatocellular carcinoma: can gadoxetic acid-enhanced magnetic resonance imaging replace combining gadopentetate dimeglumine- enhanced and superparamagnetic iron oxide-enhanced magnetic resonance imaging?", Invest Radiol, 45, pp.740~746 (2010)
- Huppertz A, "Improved detection of focal liver lesions at MR imaging: multicenter comparison of gadoxetic acid-enhanced MR images with intraoperative findings", Radiology, 230, pp.266~275 (2004)
- Bruix J, "Management of hepatocellular carcinoma: an update", Hepatology, 53, pp.1020~1022 (2011)
- Jung KS, "Risk assessment of hepatitis B virus-related hepatocellular carcinoma development using liver stiffness measurement (FibroScan)", Hepatology, 53, pp.885~894 (2011)
- Vauthey JN, "Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases", J Clin Oncol, 24, pp.2065~2072 (2006)
- Chen J, "Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography", Radiology, 259, pp.749~756 (2011)
- Colagrande S, "MR-diffusion weighted imaging of healthy liver parenchyma: repeatability and reproducibility of apparent diffusion coefficient measurement", J Magn Reson Imaging, 31, pp.912~920 (2010)
- Yin M, "Assessment of hepatic fibrosis with magnetic resonance elastography", Clin Gastroenterol Hepatol, 5, pp.1207~1213 (2007)
- Kim BH, "MR elastography for noninvasive assessment of hepatic fibrosis: experience from a tertiary center in asia", J Magn Reson Imaging, 34, pp.1110~1116 (2011)
- Poynard T, "Prospective analysis of discordant results between biochemical markers and biopsy in patients with chronic hepatitis C", Clin Chem, 50, pp.1344~1355 (2004)
- Dienstag JL, "The role of liver biopsy in chronic hepatitis C", Hepatology, 36, pp.S152~S160 (2002)
- Gebo KA, "Role of liver biopsy in management of chronic hepatitis C: a systematic review", Hepatology, 36, pp.S161~S172 (2002)
- Dzyubak B, "Automated liver stiffness measurements with magnetic resonance elastography", J Magn Reson Imaging, 38, pp.371~379 (2013)