Staging liver fibrosis in chronic hepatitis B with T1 relaxation time index on gadoxetic acid‐enhanced MRI: Comparison with aspartate aminotransferase‐to‐platelet ratio index and FIB‐4. Issue 4 (26th August 2016)

• Record Type: Journal Article
• Authors: Yang, Li; Ding, Ying; Rao, Shengxiang; Chen, Caizhong; Wu, Lifang; Sheng, Ruofan; Fu, Caixia; Zeng, Mengsu
• Is Part Of: Journal of magnetic resonance imaging. Volume 45:Issue 4(2017)
• Page Start: 1186
• Page End: 1194
• Publication Date: 2016-08-26
• Subjects: chronic hepatitis B -- gadoxetic acid -- magnetic resonance imaging -- T1 relaxation time -- liver fibrosis -- serum markers; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.25440
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Purpose: To assess the accuracy of the T 1 relaxation time index on gadoxetic acid‐enhanced magnetic resonance imaging (MRI) for staging liver fibrosis in chronic hepatitis B (CHB), in comparison and combination with the aspartate aminotransferase‐to‐platelet ratio index (APRI) and fibrosis‐4 (FIB‐4). Materials and Methods: A retrospective study of gadoxetic acid‐enhanced T 1 mapping and serum biochemical tests was performed on 126 CHB patients who underwent gadoxetic acid‐enhanced 1.5T MRI, and the histological score used as the gold standard. The reduction rate of T 1 relaxation time before and 20 minutes after gadoxetic acid injection (Δ T 1, ΔR1%), the contrast uptake rate (KHep ), APRI, and FIB‐4 were calculated. The diagnostic efficacy of Δ T 1, ΔR1%, KHep, APRI, and FIB‐4 for predicting stage 2 or greater (≥S2), stage 3 or greater (≥S3), and stage 4 (S4) was compared. Results: Δ T 1 ( r = −0.513, P < 0.001), ΔR1% ( r = −0.626, P < 0.001), KHep ( r = −0.527, P < 0.001), APRI ( r = 0.519, P < 0.001), and FIB‐4 ( r = 0.476, P < 0.001) correlated significantly with fibrosis stages. Areas under the curves (AUCs) of ΔR1% for detecting ≥S2, ≥S3, and S4 were 0.849, 0.827, and 0.809, which were greater than that of APRI (0.763, 0.745, 0.787) and FIB‐4 (0.727, 0.738, 0.772), but significant difference was found only in discriminating ≥S2 between ΔR1% and FIB‐4 ( P = 0.027). The combination of all five indices performed best, with AUC, sensitivity, and specificity of 0.860, 87.21%, and 72.50% for diagnosing ≥S2, 0.878, 82.81%, and 85.48% for ≥S3, and 0.867, 80.00%, and 83.95% for S4. Conclusion: The gadoxetic acid‐enhanced T 1 relaxation time index appears to be superior to APRI and FIB‐4 for predicting hepatic fibrosis. The combined use of gadoxetic acid‐enhanced T 1 mapping, APRI, and FIB‐4 may be more reliable for staging liver fibrosis in CHB. Level of Evidence: 4 J. Magn. Reson. Imaging 2017;45:1186–1194