MR relaxometry in chronic liver diseases: Comparison of T1 mapping, T2 mapping, and diffusion-weighted imaging for assessing cirrhosis diagnosis and severity. Issue 8 (August 2015)

• Record Type: Journal Article
• Authors: Cassinotto, Christophe; Feldis, Matthieu; Vergniol, Julien; Mouries, Amaury; Cochet, Hubert; Lapuyade, Bruno; Hocquelet, Arnaud; Juanola, Etienne; Foucher, Juliette; Laurent, François; De Ledinghen, Victor
• Is Part Of: European journal of radiology. Volume 84:Issue 8(2015)
• Page Start: 1459
• Page End: 1465
• Publication Date: 2015-08
• Subjects: Child-Pugh Child-Pugh-Turcotte score -- MELD Model for End-Stage Liver Disease score -- MR magnetic resonance -- ADC apparent diffusion coefficient -- LSM liver stiffness measurement -- BMI body mass index -- GGT gamma-glutamyl transpeptidase -- AST aspartate aminotransferase -- ALT alanine aminotransferase -- PDFF proton density fat fraction -- TR repetition time -- TE echo time -- MOLLI Modified Look-Locker Inversion Recovery -- TI inversion time; Magnetic resonance imaging -- MR relaxometry -- T1 mapping -- Diffusion-weighted imaging -- Cirrhosis -- Liver diseases; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2015.05.019
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: The use of MR to classify cirrhosis in different stages is a new interesting field. We compared liver and spleen T1 mapping, T2 mapping and diffusion-weighted imaging. MR relaxometry using liver T1 mapping is accurate for the diagnosis of cirrhosis. Liver T1 mapping shows that values increase with the severity of cirrhosis. Diffusion-weighted imaging is less accurate than T1 mapping while T2 mapping is not reliable. Abstract: Background: MR relaxometry has been extensively studied in the field of cardiac diseases, but its contribution to liver imaging is unclear. We aimed to compare liver and spleen T1 mapping, T2 mapping, and diffusion-weighted MR imaging (DWI) for assessing the diagnosis and severity of cirrhosis. Methods: We prospectively included 129 patients with normal ( n = 40) and cirrhotic livers ( n = 89) from May to September 2014. Non-enhanced liver T1 mapping, splenic T2 mapping, and liver and splenic DWI were measured and compared for assessing cirrhosis severity using Child-Pugh score, MELD score, and presence or not of large esophageal varices (EVs) and liver stiffness measurements using Fibroscan ® as reference. Results: Liver T1 mapping was the only variable demonstrating significant differences between normal patients (500 ± 79 ms), Child-Pugh A patients (574 ± 84 ms) and Child-Pugh B/C patients (690 ± 147 ms; all p -values <0.00001). Liver T1 mapping had a significant correlation with Child-Pugh score (Pearson's correlation coefficient of 0.46), MEDL score (0.30), and liver stiffness measurement (0.52). Areas under the receiver operating characteristic curves of liver T1 mapping for the diagnosis of cirrhosis (O.85; 95% confidence intervals (CI), 0.77–0.91), Child-Pugh B/C cirrhosis (0.87; 95%CI, 0.76–0.93), and large EVs (0.75; 95%CI, 0.63–0.83) were greater than that of spleen T2 mapping, liver and spleen DWI (all p -values < 0.01). Conclusion: Liver T1 mapping is a promising new diagnostic tool for assessing cirrhosis diagnosis and severity, showing higher diagnostic accuracy than liver and spleen DWI, while T2 mapping is not reliable.