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European Radiology

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01-02-2016 | Magnetic Resonance

The diagnostic efficacy of quantitative liver MR imaging with diffusion-weighted, SWI, and hepato-specific contrast-enhanced sequences in staging liver fibrosis—a multiparametric approach

Authors: Diana Feier, Csilla Balassy, Nina Bastati, Romana Fragner, Friedrich Wrba, Ahmed Ba-Ssalamah

Published in: European Radiology | Issue 2/2016

Abstract

Purpose

To assess the diagnostic efficacy of multiparametric MRI using quantitative measurements of the apparent diffusion coefficient (ADC) of the liver parenchyma on diffusion-weighted imaging (DWI), signal intensity (SI) on susceptibility-weighted imaging (SWI), and gadoxetic acid-enhanced T1-weighted imaging during the hepatobiliary phase for the staging of liver fibrosis.

Materials and Methods

Seventy-seven patients underwent a 3T MRI examination, including DWI/SWI sequences and gadoxetic acid-enhanced T1-weighted MRI. Liver fibrosis according to liver biopsy was staged using the Metavir fibrosis score: F0 (n = 21, 27.3 %); F1 (n = 7, 9.1 %); F2 (n = 8, 10.4 %); F3 (n = 12, 15.6 %); and F4 (n = 29, 37.7 %). SI of the liver was defined using region-of-interest measurements to calculate the ADC values, the relative enhancement (RE) in the hepatobiliary phase, and the liver-to-muscle ratio (LMR) measurements for SWI.

Results

The values of RE, LMR, and ADC measurements were statistically significantly different among the five fibrosis stages (p < 0.004). Combining the three parameters in a multiparametric approach, the AUC for detecting F1 stage or greater (≥ F1) was 94 %, for F2 or greater (≥F2) was 95 %, for F3 or greater (≥F3) was 90 %, and for stage F4 was 93 %.

Conclusions

Multiparametric MRI is an efficient non-invasive diagnostic tool for the staging of liver fibrosis.

Key Points

• Multiparametric MRI has high accuracy in predicting moderate or greater liver fibrosis.

• Relative enhancement post- gadoxetic acid is an independent predictor of liver fibrosis.

• Liver SWI signal intensity and ADC values enhance the diagnostic ability.

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Title: The diagnostic efficacy of quantitative liver MR imaging with diffusion-weighted, SWI, and hepato-specific contrast-enhanced sequences in staging liver fibrosis—a multiparametric approach
Authors: Diana Feier
Csilla Balassy
Nina Bastati
Romana Fragner
Friedrich Wrba
Ahmed Ba-Ssalamah
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3830-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The diagnostic efficacy of quantitative liver MR imaging with diffusion-weighted, SWI, and hepato-specific contrast-enhanced sequences in staging liver fibrosis—a multiparametric approach

Abstract

Purpose

Materials and Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusions

Key Points

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