Feasibility of Spin-Echo Echo-Planar Imaging MR Elastography in Livers of Children and Young Adults
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: To assess the feasibility of the use of spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) in livers of children and young adults. Materials and Methods: Patients (≤ 20 years old) who underwent 3T SE-EPI MRE were included retrospectively. Subjects were divided into three groups according to the purpose of the liver MRI: suspicion of fatty liver or focal fat deposition in the liver (FAT group), liver fibrosis after receiving a Kasai operation from biliary atresia (BA group), and hepatic iron deposition after receiving chemotherapy or transfusions (IRON group). Technical failure of MRE was defined when a stiffness map showed no pixel value with a confidence index higher than 95%, and the patients were divided as success and failure groups accordingly. Clinical findings including age, gender, weight, height, and body mass index and magnetic resonance imaging results including proton density fat fraction (PDFF), T2*, and MRE values were assessed. Factors affecting failure of MRE were evaluated and the image quality in wave propagation image and stiffness map was evaluated using the appropriate scores. Results: Among total 240 patients (median 15 years, 211 patients in the FAT, 21 patients in the BA, and 8 patients in the IRON groups), technical failure was noted in six patients in the IRON group (6/8 patients, 75%), while there were no failures noted in the FAT and BA groups. These six patients had T2* values ranging from 0.9 to 3.8 ms. The image quality scores were not significantly different between the FAT and BA groups (P > 0.999), while the scores were significantly lower in the IRON group (P < 0.001). Conclusion: The 3T SE-EPI MRE in children and young adults had a high technical success rate. The technical failure was occurred in children with decreased T2* value (≤ 3.8 ms) from iron deposition.
Abstract
Purpose: To assess the feasibility of the use of spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) in livers of children and young adults. Materials and Methods: Patients (≤ 20 years old) who underwent 3T SE-EPI MRE were included retrospectively. Subjects were divided into three groups according to the purpose of the liver MRI: suspicion of fatty liver or focal fat deposition in the liver (FAT group), liver fibrosis after receiving a Kasai operation from biliary atresia (BA group), and hepatic iron deposition after receiving chemotherapy or transfusions (IRON group). Technical failure of MRE was defined when a stiffness map showed no pixel value with a confidence index higher than 95%, and the patients were divided as success and failure groups accordingly. Clinical findings including age, gender, weight, height, and body mass index and magnetic resonance imaging results including proton density fat fraction (PDFF), T2*, and MRE values were assessed. Factors affecting failure of MRE were evaluated and the image quality in wave propagation image and stiffness map was evaluated using the appropriate scores. Results: Among total 240 patients (median 15 years, 211 patients in the FAT, 21 patients in the BA, and 8 patients in the IRON groups), technical failure was noted in six patients in the IRON group (6/8 patients, 75%), while there were no failures noted in the FAT and BA groups. These six patients had T2* values ranging from 0.9 to 3.8 ms. The image quality scores were not significantly different between the FAT and BA groups (P > 0.999), while the scores were significantly lower in the IRON group (P < 0.001). Conclusion: The 3T SE-EPI MRE in children and young adults had a high technical success rate. The technical failure was occurred in children with decreased T2* value (≤ 3.8 ms) from iron deposition.
참고문헌 (28)
- Bonekamp S, "Can imaging modalities diagnose and stage hepatic fibrosis and cirrhosis accurately?", J Hepatol, 50, pp.17~35 (2009)
- Mavis AM, "Liver disease in the adolescent", Clin Liver Dis, 19, pp.171~185 (2015)
- Friedman SL, "Evolving challenges in hepatic fibrosis", Nat Rev Gastroenterol Hepatol, 7, pp.425~436 (2010)
- Bortolotti F, "Reversal of liver cirrhosis: a desirable clinical outcome and its pathogenic background", J Pediatr Gastroenterol Nutr, 44, pp.401~406 (2007)
- Castera L, "Biopsy and non-invasive methods for the diagnosis of liver fibrosis: does it take two to tango?", Gut, 59, pp.861~866 (2010)
- Pariente D, "Paediatric chronic liver diseases: how to investigate and follow up? Role of imaging in the diagnosis of fibrosis", Pediatr Radiol, 40, pp.906~919 (2010)
- Kennedy P, "Quantitative elastography methods in liver disease: current evidence and future directions", Radiology, 286, pp.738~763 (2018)
- Trout AT, "Diagnostic performance of MR elastography for liver fibrosis in children and young adults with a spectrum of liver diseases", Radiology, 287, pp.824~832 (2018)
- Singh S, "Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and metaanalysis of individual participant data", Clin Gastroenterol Hepatol, 13, pp.440~451 (2015)
- Serai SD, "Spin-echo echo-planar imaging MR elastography versus gradient-echo MR elastography for assessment of liver stiffness in children and young adults suspected of having liver disease", Radiology, 282, pp.761~770 (2017)
- Kim YS, "Comparison of gradient-recalled echo and spin-echo echo-planar imaging MR elastography in staging liver fibrosis: a meta-analysis", Eur Radiol, 28, pp.1709~1718 (2018)
- Felker ER, "Liver MR elastography at 3 T: agreement across pulse sequences and effect of liver R2* on image quality", AJR Am J Roentgenol, 211, pp.588~594 (2018)
- Wagner M, "Technical failure of MR elastography examinations of the liver: experience from a large single-center study", Radiology, 284, pp.401~412 (2017)
- Joshi M, "MR elastography: high rate of technical success in pediatric and young adult patients", Pediatr Radiol, 47, pp.838~843 (2017)
- Alustiza Echeverria JM, "Quantification of iron concentration in the liver by MRI", Insights Imaging, 3, pp.173~180 (2012)
- Shin HJ, "Normal range of hepatic fat fraction on dual- and triple-echo fat quantification MR in children", PLoS One, 10, pp.e0117480~ (2015)
- Wahidiyat PA, "Evaluation of iron overload between age groups using magnetic resonance imaging and its correlation with iron profile in transfusiondependent thalassemia", Acta Med Indones, 50, pp.230~236 (2018)
- Serai SD, "Pediatric liver MR elastography", Dig Dis Sci, 57, pp.2713~2719 (2012)
- Binkovitz LA, "Pediatric MR elastography of hepatic fibrosis:principles, technique and early clinical experience", Pediatr Radiol, 42, pp.402~409 (2012)
- Petitclerc L, "Liver fibrosis: review of current imaging and MRI quantification techniques", J Magn Reson Imaging, 45, pp.1276~1295 (2017)
- Mariappan YK, "Magnetic resonance elastography: a review", Clin Anat, 23, pp.497~511 (2010)
- Srinivasa Babu A, "Elastography in chronic liver disease: modalities, techniques, limitations, and future directions", Radiographics, 36, pp.1987~2006 (2016)
- Wagner M, "Magnetic resonance elastography of the liver: qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences", Invest Radiol, 51, pp.575~581 (2016)
- Rump J, "Fractional encoding of harmonic motions in MR elastography", Magn Reson Med, 57, pp.388~395 (2007)
- Venkatesh SK, "Magnetic resonance elastography of liver: technique, analysis, and clinical applications", J Magn Reson Imaging, 37, pp.544~555 (2013)
- Yin M, "Hepatic MR elastography: clinical performance in a series of 1377 consecutive examinations", Radiology, 278, pp.114~124 (2016)
- Serai SD, "Can MR elastography be used to measure liver stiffness in patients with iron overload?", Abdom Radiol (NY), 44, pp.104~109 (2019)
- Kim YS, "Comparison of spin-echo echoplanar imaging and gradient recalled echo-based MR elastography at 3 Tesla with and without gadoxetic acid administration", Eur Radiol, 27, pp.4120~4128 (2017)
