Top

Insights into Imaging

Published in:

Open Access 01-12-2024 | Hepatitis | Original Article

Viscoelastic parameters derived from multifrequency MR elastography for depicting hepatic fibrosis and inflammation in chronic viral hepatitis

Authors: Yikun Wang, Jiahao Zhou, Huimin Lin, Huafeng Wang, Ingolf Sack, Jing Guo, Fuhua Yan, Ruokun Li

Published in: Insights into Imaging | Issue 1/2024

Abstract

Objectives

The capability of MR elastography (MRE) to differentiate fibrosis and inflammation, and to provide precise diagnoses is crucial, whereas the coexistence of fibrosis and inflammation may obscure the diagnostic accuracy.

Methods

In this retrospective study, from June 2020 to December 2022, chronic viral hepatitis patients who underwent multifrequency MRE (mMRE) were included in, and further divided into, training and validation cohorts. The hepatic viscoelastic parameters [shear wave speed (c) and loss angle (φ) of the complex shear modulus] were obtained from mMRE. The logistic regression and receiver operating characteristic (ROC) curves were generated to evaluate performance of viscoelastic parameters for fibrosis and inflammation.

Results

A total of 233 patients were assigned to training cohort and validation cohorts (mean age, 52 years ± 13 (SD); 51 women; training cohort, n = 170 (73%), and validation cohort, n = 63 (27%)). Liver c exhibited superior performance in detecting fibrosis with ROC (95% confidence interval) of ≥ S1 (0.96 (0.92–0.99)), ≥ S2 (0.86 (0.78–0.92)), ≥ S3 (0.89 (0.84–0.95)), and S4 (0.88 (0.83–0.93)). Similarly, φ was effective in diagnosing inflammation with ROC values of ≥ G2 (0.72 (0.63–0.81)), ≥ G3 (0.88 (0.83–0.94)), and G4 (0.92 (0.87–0.98)). And great predictive discrimination for fibrosis and inflammation were shown in validation cohort (all AUCs > 0.75).

Conclusion

The viscoelastic parameters derived from multifrequency MRE could realize simultaneous detection of hepatic fibrosis and inflammation.

Critical relevance statement

Fibrosis and inflammation coexist in chronic liver disease which obscures the diagnostic performance of MR elastography, whereas the viscoelastic parameters derived from multifrequency MR elastography could realize simultaneous detection of hepatic fibrosis and inflammation.

Key points

• Hepatic biomechanical parameters derived from multifrequency MR elastography could effectively detect fibrosis and inflammation.

• Liver stiffness is useful for detecting fibrosis independent of inflammatory activity.

• Fibrosis could affect the diagnostic efficacy of liver viscosity in inflammation, especially in early-grade of inflammation.

Graphical Abstract

Available only for authorised users

Asrani SK, Devarbhavi H, Eaton J, Kamath PS (2019) Burden of liver diseases in the world. J Hepatol 70:151–171CrossRefPubMed

Setiawan VW, Stram DO, Porcel J, Lu SC, Le Marchand L, Noureddin M (2016) Prevalence of chronic liver disease and cirrhosis by underlying cause in understudied ethnic groups: the multiethnic cohort. Hepatology 64:1969–1977CrossRefPubMed

Wang G, Duan Z (2021) Guidelines for prevention and treatment of chronic hepatitis B. J Clin Transl Hepatol 9:769–791PubMedPubMedCentral

Altamirano-Barrera A, Barranco-Fragoso B, Mendez-Sanchez N (2017) Management strategies for liver fibrosis. Ann Hepatol 16:48–56CrossRefPubMed

Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD (2009) American Association for the Study of Liver D: liver biopsy. Hepatology 49:1017–1044CrossRefPubMed

Bedossa P, Dargere D, Paradis V (2003) Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 38:1449–1457CrossRefPubMed

Selvaraj EA, Mozes FE, Jayaswal ANA et al (2021) Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: a systematic review and meta-analysis. J Hepatol 75:770–785CrossRefPubMed

Yin Z, Murphy MC, Li J et al (2019) Prediction of nonalcoholic fatty liver disease (NAFLD) activity score (NAS) with multiparametric hepatic magnetic resonance imaging and elastography. Eur Radiol 29:5823–5831CrossRefPubMedPubMedCentral

Liang JX, Ampuero J, Niu H et al (2023) An individual patient data meta-analysis to determine cut-offs for and confounders of NAFLD-fibrosis staging with magnetic resonance elastography. J Hepatol 79:592–604CrossRefPubMed

10.

Allen AM, Shah VH, Therneau TM et al (2020) The role of three-dimensional magnetic resonance elastography in the diagnosis of nonalcoholic steatohepatitis in obese patients undergoing bariatric surgery. Hepatology 71:510–521CrossRefPubMed

11.

Shi Y, Qi YF, Lan GY et al (2021) Three-dimensional MR elastography depicts liver inflammation, fibrosis, and portal hypertension in chronic hepatitis B or C. Radiology 301:154–162CrossRefPubMed

12.

Reiter R, Tzschatzsch H, Schwahofer F et al (2020) Diagnostic performance of tomoelastography of the liver and spleen for staging hepatic fibrosis. Eur Radiol 30:1719–1729CrossRefPubMed

13.

Hirsch S, Guo J, Reiter R et al (2014) MR elastography of the liver and the spleen using a piezoelectric driver, single-shot wave-field acquisition, and multifrequency dual parameter reconstruction. Magn Reson Med 71:267–277CrossRefPubMed

14.

Shi Y, Guo Q, Xia F et al (2014) MR elastography for the assessment of hepatic fibrosis in patients with chronic hepatitis B infection: does histologic necroinflammation influence the measurement of hepatic stiffness? Radiology 273:88–98CrossRefPubMed

15.

Ichikawa S, Motosugi U, Nakazawa T et al (2015) Hepatitis activity should be considered a confounder of liver stiffness measured with MR elastography. J Magn Reson Imaging 41:1203–1208CrossRefPubMed

16.

Collins GS, Reitsma JB, Altman DG, Moons KGM, members of the Tg (2015) Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. Eur Urol 67:1142–1151CrossRefPubMed

17.

Tzschatzsch H, Guo J, Dittmann F et al (2016) Tomoelastography by multifrequency wave number recovery from time-harmonic propagating shear waves. Med Image Anal 30:1–10CrossRefPubMed

18.

Manduca A, Bayly PJ, Ehman RL et al (2021) MR elastography: principles, guidelines, and terminology. Magn Reson Med 85:2377–2390CrossRefPubMed

19.

Scheuer PJ (1995) The nomenclature of chronic hepatitis: time for a change. J Hepatol 22:112–114CrossRefPubMed

20.

Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ (1994) Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 19:1513–1520CrossRefPubMed

21.

Yin M, Glaser KJ, Manduca A et al (2017) Distinguishing between hepatic inflammation and fibrosis with MR elastography. Radiology 284:694–705CrossRefPubMed

22.

Tan Z, Liu Q, Jiang R et al (2018) Interleukin-33 drives hepatic fibrosis through activation of hepatic stellate cells. Cell Mol Immunol 15:388–398CrossRefPubMed

23.

Chiazza F, Couturier-Maillard A, Benetti E et al (2016) Targeting the NLRP3 inflammasome to reduce diet-induced metabolic abnormalities in mice. Mol Med 21:1025–1037CrossRefPubMedPubMedCentral

24.

Scheuer PJ (1991) Classification of chronic viral hepatitis: a need for reassessment. J Hepatol 13:372–374CrossRefPubMed

25.

Wang J, Shan Q, Liu Y et al (2019) 3D MR elastography of hepatocellular carcinomas as a potential biomarker for predicting tumor recurrence. J Magn Reson Imaging 49:719–730CrossRefPubMed

26.

Hsu C, Caussy C, Imajo K et al (2019) Magnetic resonance vs transient elastography analysis of patients with nonalcoholic fatty liver disease: a systematic review and pooled analysis of individual participants. Clin Gastroenterol Hepatol 17:630–637.e638CrossRefPubMed

Title: Viscoelastic parameters derived from multifrequency MR elastography for depicting hepatic fibrosis and inflammation in chronic viral hepatitis
Authors: Yikun Wang
Jiahao Zhou
Huimin Lin
Huafeng Wang
Ingolf Sack
Jing Guo
Fuhua Yan
Ruokun Li
Publication date: 01-12-2024
Publisher: Springer Vienna
Keyword: Hepatitis
Published in: Insights into Imaging / Issue 1/2024
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-024-01652-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Viscoelastic parameters derived from multifrequency MR elastography for depicting hepatic fibrosis and inflammation in chronic viral hepatitis

Abstract

Objectives

Methods

Results

Conclusion

Critical relevance statement

Key points

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Critical relevance statement

Key points

Graphical Abstract

Please log in to get access to this content

Other articles of this Issue 1/2024

Convolutional neural networks for the differentiation between benign and malignant renal tumors with a multicenter international computed tomography dataset

Correlation between CEUS LI-RADS categorization of HCC < 20 mm and clinic-pathological features

The value of machine learning based on CT radiomics in the preoperative identification of peripheral nerve invasion in colorectal cancer: a two-center study

PI-RADS v2.1 evaluation of prostate “nodule in nodule” variants: clinical, imaging, and pathological features

Computed tomography-based body composition parameters can predict short-term prognosis in ulcerative colitis patients

The differences between carotid web and carotid web with plaque: based on multimodal ultrasonic and clinical characteristics