Liver MRI and histological correlates in chronic liver disease on multiphase gadolinium-enhanced 3D gradient echo imaging

Diego R Martin, Thomas Lauenstein, Bobby T Kalb, Christina Lurie, Hiroumi Kitajima, Puneet Sharma, Khalil Salman, Roger Moreira, Alton B. Farris, James Spivey, Enrique Martinez, Steve Hanish, Volkan Adsay

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To evaluate intrinsic hepatic enhancement patterns on multiphase, gadolinium-enhanced, fat-suppressed, 3D T1-weighted, gradient echo magnetic resonance imaging (MRI) as a quantitative correlate for severity of pathological changes in chronic liver disease (CLD). Materials and Methods: This study was HIPAA-compliant and Institutional Review Board-approved. In all, 75 patients were studied by contrast-enhanced multiphase abdominal MRI. CLD patients had liver histology correlation derived from right lobe liver biopsies. Contrast-enhanced arterial- and delayed-phase 3D gradient recalled echo (GRE) liver MRI were scored using feature categorization templates to quantify enhancement patterns by three independent readers. Liver histopathology was staged/graded for fibrosis/inflammation using the Scheuer system. Statistical testing for MRI histology correlates used a Pearson's product moment correlation and a Wilcoxon-Mann-Whitney two-sample rank-sum test. Reader agreement was analyzed by a modified Fleiss' kappa test. Results: MRI histology correlation was high for delayed-phase MRI versus fibrosis stage (95% confidence interval [CI] 0.941 < r < 0.976, P = 5 × 10-7), but lower for all other comparisons (delayed-phase vs. inflammation and arterial-phase vs. inflammation or fibrosis all showed a CI no greater than 0.64). Paired testing between delayed-phase MRI score and histology fibrosis staging incremental levels was significant (from P < 10-2 to P < 10-5). Conclusion: A standard gadolinium-enhanced liver MRI may provide a correlate measure of hepatic fibrosis over a spectrum of severity.

Original languageEnglish (US)
Pages (from-to)422-429
Number of pages8
JournalJournal of Magnetic Resonance Imaging
Volume36
Issue number2
DOIs
StatePublished - Aug 2012

Fingerprint

Gadolinium
Liver Diseases
Chronic Disease
Magnetic Resonance Imaging
Liver
Fibrosis
Histology
Confidence Intervals
Inflammation
Health Insurance Portability and Accountability Act
Arteritis
Research Ethics Committees
Nonparametric Statistics
Fats
Biopsy

Keywords

  • chronic hepatitis
  • chronic liver disease
  • hepatitis
  • histology
  • liver biopsy
  • liver fibrosis
  • MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Liver MRI and histological correlates in chronic liver disease on multiphase gadolinium-enhanced 3D gradient echo imaging. / Martin, Diego R; Lauenstein, Thomas; Kalb, Bobby T; Lurie, Christina; Kitajima, Hiroumi; Sharma, Puneet; Salman, Khalil; Moreira, Roger; Farris, Alton B.; Spivey, James; Martinez, Enrique; Hanish, Steve; Adsay, Volkan.

In: Journal of Magnetic Resonance Imaging, Vol. 36, No. 2, 08.2012, p. 422-429.

Research output: Contribution to journalArticle

Martin, DR, Lauenstein, T, Kalb, BT, Lurie, C, Kitajima, H, Sharma, P, Salman, K, Moreira, R, Farris, AB, Spivey, J, Martinez, E, Hanish, S & Adsay, V 2012, 'Liver MRI and histological correlates in chronic liver disease on multiphase gadolinium-enhanced 3D gradient echo imaging', Journal of Magnetic Resonance Imaging, vol. 36, no. 2, pp. 422-429. https://doi.org/10.1002/jmri.23668
Martin, Diego R ; Lauenstein, Thomas ; Kalb, Bobby T ; Lurie, Christina ; Kitajima, Hiroumi ; Sharma, Puneet ; Salman, Khalil ; Moreira, Roger ; Farris, Alton B. ; Spivey, James ; Martinez, Enrique ; Hanish, Steve ; Adsay, Volkan. / Liver MRI and histological correlates in chronic liver disease on multiphase gadolinium-enhanced 3D gradient echo imaging. In: Journal of Magnetic Resonance Imaging. 2012 ; Vol. 36, No. 2. pp. 422-429.
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abstract = "Purpose: To evaluate intrinsic hepatic enhancement patterns on multiphase, gadolinium-enhanced, fat-suppressed, 3D T1-weighted, gradient echo magnetic resonance imaging (MRI) as a quantitative correlate for severity of pathological changes in chronic liver disease (CLD). Materials and Methods: This study was HIPAA-compliant and Institutional Review Board-approved. In all, 75 patients were studied by contrast-enhanced multiphase abdominal MRI. CLD patients had liver histology correlation derived from right lobe liver biopsies. Contrast-enhanced arterial- and delayed-phase 3D gradient recalled echo (GRE) liver MRI were scored using feature categorization templates to quantify enhancement patterns by three independent readers. Liver histopathology was staged/graded for fibrosis/inflammation using the Scheuer system. Statistical testing for MRI histology correlates used a Pearson's product moment correlation and a Wilcoxon-Mann-Whitney two-sample rank-sum test. Reader agreement was analyzed by a modified Fleiss' kappa test. Results: MRI histology correlation was high for delayed-phase MRI versus fibrosis stage (95{\%} confidence interval [CI] 0.941 < r < 0.976, P = 5 × 10-7), but lower for all other comparisons (delayed-phase vs. inflammation and arterial-phase vs. inflammation or fibrosis all showed a CI no greater than 0.64). Paired testing between delayed-phase MRI score and histology fibrosis staging incremental levels was significant (from P < 10-2 to P < 10-5). Conclusion: A standard gadolinium-enhanced liver MRI may provide a correlate measure of hepatic fibrosis over a spectrum of severity.",
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AU - Kitajima, Hiroumi

AU - Sharma, Puneet

AU - Salman, Khalil

AU - Moreira, Roger

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AU - Martinez, Enrique

AU - Hanish, Steve

AU - Adsay, Volkan

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AB - Purpose: To evaluate intrinsic hepatic enhancement patterns on multiphase, gadolinium-enhanced, fat-suppressed, 3D T1-weighted, gradient echo magnetic resonance imaging (MRI) as a quantitative correlate for severity of pathological changes in chronic liver disease (CLD). Materials and Methods: This study was HIPAA-compliant and Institutional Review Board-approved. In all, 75 patients were studied by contrast-enhanced multiphase abdominal MRI. CLD patients had liver histology correlation derived from right lobe liver biopsies. Contrast-enhanced arterial- and delayed-phase 3D gradient recalled echo (GRE) liver MRI were scored using feature categorization templates to quantify enhancement patterns by three independent readers. Liver histopathology was staged/graded for fibrosis/inflammation using the Scheuer system. Statistical testing for MRI histology correlates used a Pearson's product moment correlation and a Wilcoxon-Mann-Whitney two-sample rank-sum test. Reader agreement was analyzed by a modified Fleiss' kappa test. Results: MRI histology correlation was high for delayed-phase MRI versus fibrosis stage (95% confidence interval [CI] 0.941 < r < 0.976, P = 5 × 10-7), but lower for all other comparisons (delayed-phase vs. inflammation and arterial-phase vs. inflammation or fibrosis all showed a CI no greater than 0.64). Paired testing between delayed-phase MRI score and histology fibrosis staging incremental levels was significant (from P < 10-2 to P < 10-5). Conclusion: A standard gadolinium-enhanced liver MRI may provide a correlate measure of hepatic fibrosis over a spectrum of severity.

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