Magnetic Resonance Elastography and Diffusion Weighted Imaging in the Evaluation of Hepatic Fibrosis in Chronic Hepatitis B
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Background/Aims: Comparison of the accuracy of magnetic resonance elastography (MRE) and diffusion weighted imaging (DWI) for the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB). Methods: In this retrospective analysis, we investigated 63 patients with CHB and liver fibrosis. DWI was performed with both breath-hold (DWIBH) and free-breathing (DWI-FB) sequences (b=0, 500). The mean liver stiffness and apparent diffusion coefficient (ADC) were calculated by drawing regions of interest maps. Fibrosis staging according to the METAVIR system was independently performed by an experienced pathologist. A receiver operating curve (ROC) analysis was conducted to determine the accuracy of MRE, DWI-BH and DWI-FB in the detection and stratification of liver fibrosis. The performance of the detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was also evaluated by comparing areas under the ROC. Results: There was a moderate and significantly negative correlation between the ADC values and liver stiffness. The accuracies for the detection of ≥F2/≥F3/F4 stage fibrosis with DWI-FB, DWI-BH and MRE were 0.84/0.76/0.72, 0.72/0.83/0.79 and 0.99/0.99/0.98, respectively. The performance of MRE was significantly better than DWI-FB and DWI-BH. There were no significant differences between the performance of DWI-FB and DWI-BH. Conclusions: MRE is more accurate than DWI for the detection and stratification of liver fibrosis in CHB.
Abstract
Background/Aims: Comparison of the accuracy of magnetic resonance elastography (MRE) and diffusion weighted imaging (DWI) for the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB). Methods: In this retrospective analysis, we investigated 63 patients with CHB and liver fibrosis. DWI was performed with both breath-hold (DWIBH) and free-breathing (DWI-FB) sequences (b=0, 500). The mean liver stiffness and apparent diffusion coefficient (ADC) were calculated by drawing regions of interest maps. Fibrosis staging according to the METAVIR system was independently performed by an experienced pathologist. A receiver operating curve (ROC) analysis was conducted to determine the accuracy of MRE, DWI-BH and DWI-FB in the detection and stratification of liver fibrosis. The performance of the detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was also evaluated by comparing areas under the ROC. Results: There was a moderate and significantly negative correlation between the ADC values and liver stiffness. The accuracies for the detection of ≥F2/≥F3/F4 stage fibrosis with DWI-FB, DWI-BH and MRE were 0.84/0.76/0.72, 0.72/0.83/0.79 and 0.99/0.99/0.98, respectively. The performance of MRE was significantly better than DWI-FB and DWI-BH. There were no significant differences between the performance of DWI-FB and DWI-BH. Conclusions: MRE is more accurate than DWI for the detection and stratification of liver fibrosis in CHB.
참고문헌 (22)
- Friedman SL, "Reversal of hepatic fibrosis: fact or fantasy", Hepatology, 43(2 Suppl 1), pp.S82~S88 (2006)
- Enomoto M, "Usefulness of transient elastography for assessment of liver fibrosis in chronic hepatitis B: regression of liver stiffness during entecavir therapy", Hepatol Res, 40, pp.853~861 (2010)
- Bortolotti F, "Spontaneous regression of hepatitis B virus-associated cirrhosis developed in childhood", Dig Liver Dis, 37, pp.964~967 (2005)
- Bortolotti F, "Interferon treatment in children with chronic hepatitis C: long-lasting remission in responders, and risk for disease progression in non-responders", Dig Liver Dis, 37, pp.336~341 (2005)
- Colloredo G, "Impact of liver biopsy size on histological evaluation of chronic viral hepatitis: the smaller the sample, the milder the disease", J Hepatol, 39, pp.239~244 (2003)
- Guido M, "Liver biopsy sampling in chronic viral hepatitis", Semin Liver Dis, 24, pp.89~97 (2004)
- Regev A, "Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection", Am J Gastroenterol, 97, pp.2614~2618 (2002)
- Westin J, "Interobserver study of liver histopathology using the Ishak score in patients with chronic hepatitis C virus infection", Liver, 19, pp.183~187 (1999)
- Cadranel JF, "Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF)", Hepatology, 32, pp.477~481 (2000)
- Venkatesh SK, "Non-invasive detection of liver fibrosis: MR imaging features vs. MR elastography", Abdom Imaging, 40, pp.766~775 (2015)
- Ayvaz S, "Efficacy of diffusion-weighted mri in the evaluation of extrahepatic cholestasis-related hepatic fibrosis", Turk J Med Sci, 45, pp.686~693 (2015)
- Hu XR, "Value of MR diffusion imaging in hepatic fibrosis and its correlations with serum indices", World J Gastroenterol, 20, pp.7964~7970 (2014)
- Ding Y, "Liver fibrosis staging using T1 mapping on gadoxetic acid-enhanced MRI compared with DW imaging", Clin Radiol, 70, pp.1096~1103 (2015)
- Park HS, "Three- Tesla magnetic resonance elastography for hepatic fibrosis: comparison with diffusion-weighted imaging and gadoxetic acidenhanced magnetic resonance imaging", World J Gastroenterol, 20, pp.17558~17567 (2014)
- Venkatesh SK, "Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B", Eur Radiol, 24, pp.70~78 (2014)
- Ichikawa S, "Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C", Magn Reson Med Sci, 11, pp.291~297 (2012)
- Wang Y, "Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusionweighted imaging", AJR Am J Roentgenol, 196, pp.553~561 (2011)
- Bedossa P, "An algorithm for the grading of activity in chronic hepatitis C: the METAVIR Cooperative Study Group", Hepatology, 24, pp.289~293 (1996)
- DeLong ER, "Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach", Biometrics, 44, pp.837~845 (1988)
- Wang QB, "Performance of magnetic resonance elastography and diffusion-weighted imaging for the staging of hepatic fibrosis: a meta-analysis", Hepatology, 56, pp.239~247 (2012)
- Zou LQ, "Comparison of magnetic resonance elastography and diffusion-weighted imaging for staging hepatic fibrosis", Chin Med J (Engl), 128, pp.620~625 (2015)
- Kim SU, "Can preoperative diffusionweighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study", Magn Reson Imaging, 28, pp.802~811 (2010)
