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Published in: Abdominal Radiology 7/2018

01-07-2018 | Pictorial essay

Magnetic resonance elastography: beyond liver fibrosis—a case-based pictorial review

Authors: Sudhakar K. Venkatesh, Michael L. Wells, Frank H. Miller, Kartik S. Jhaveri, Alvin C. Silva, Bachir Taouli, Richard L. Ehman

Published in: Abdominal Radiology | Issue 7/2018

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Abstract

Magnetic resonance elastography (MRE) has been introduced for clinical evaluation of liver fibrosis for nearly a decade. MRE has proven to be a robust and accurate technique for diagnosis and staging of liver fibrosis. As clinical experience with MRE grows, the possible role in evaluation of other diffuse and focal disorders of liver is emerging. Stiffness maps provide an opportunity to evaluate mechanical properties within a large volume of liver tissue. This enables appreciation of spatial heterogeneity of stiffness. Stiffness maps may reveal characteristic and differentiating features of chronic liver diseases and focal liver lesions and therefore provide useful information for clinical management. The objective of this pictorial review is to recapture the essentials of MRE technique and illustrate with examples, the utility of stiffness maps in other chronic liver disorders and focal liver lesions.
Literature
1.
go back to reference Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544–555CrossRefPubMedPubMedCentral Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544–555CrossRefPubMedPubMedCentral
2.
go back to reference Singh S, Venkatesh SK, Wang Z, et al. (2015) Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol 13(440–451):e6 Singh S, Venkatesh SK, Wang Z, et al. (2015) Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol 13(440–451):e6
3.
go back to reference Singh S, Venkatesh SK, Loomba R, et al. (2016) Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis. Eur Radiol 26:1431–1440CrossRefPubMed Singh S, Venkatesh SK, Loomba R, et al. (2016) Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis. Eur Radiol 26:1431–1440CrossRefPubMed
4.
go back to reference Singh S, Venkatesh SK, Keaveny A, et al. (2016) Diagnostic accuracy of magnetic resonance elastography in liver transplant recipients: a pooled analysis. Ann Hepatol 15:363–376CrossRefPubMedPubMedCentral Singh S, Venkatesh SK, Keaveny A, et al. (2016) Diagnostic accuracy of magnetic resonance elastography in liver transplant recipients: a pooled analysis. Ann Hepatol 15:363–376CrossRefPubMedPubMedCentral
5.
go back to reference Jajamovich GH, Dyvorne H, Donnerhack C, et al. (2014) Quantitative liver MRI combining phase contrast imaging, elastography, and DWI: assessment of reproducibility and postprandial effect at 3.0 T. PLoS ONE 9:e97355CrossRefPubMedPubMedCentral Jajamovich GH, Dyvorne H, Donnerhack C, et al. (2014) Quantitative liver MRI combining phase contrast imaging, elastography, and DWI: assessment of reproducibility and postprandial effect at 3.0 T. PLoS ONE 9:e97355CrossRefPubMedPubMedCentral
6.
go back to reference Yasar TK, Wagner M, Bane O, et al. (2016) Interplatform reproducibility of liver and spleen stiffness measured with MR elastography. J Magn Reson Imaging 43:1064–1072CrossRefPubMed Yasar TK, Wagner M, Bane O, et al. (2016) Interplatform reproducibility of liver and spleen stiffness measured with MR elastography. J Magn Reson Imaging 43:1064–1072CrossRefPubMed
7.
go back to reference Venkatesh SK, Wang G, Lim SG, et al. (2014) Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol 24:70–78CrossRefPubMed Venkatesh SK, Wang G, Lim SG, et al. (2014) Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol 24:70–78CrossRefPubMed
8.
go back to reference Ichikawa S, Motosugi U, Ichikawa T, et al. (2012) Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C. Magn Reson Med Sci 11:291–297CrossRefPubMed Ichikawa S, Motosugi U, Ichikawa T, et al. (2012) Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C. Magn Reson Med Sci 11:291–297CrossRefPubMed
9.
go back to reference Cui J, Heba E, Hernandez C, et al. (2016) Magnetic resonance elastography is superior to acoustic radiation force impulse for the Diagnosis of fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease: a prospective study. Hepatology 63:453–461CrossRefPubMed Cui J, Heba E, Hernandez C, et al. (2016) Magnetic resonance elastography is superior to acoustic radiation force impulse for the Diagnosis of fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease: a prospective study. Hepatology 63:453–461CrossRefPubMed
10.
go back to reference Bensamoun SF, Leclerc GE, Charleux F, et al. (2012) Magnetic resonance elastography (MRE): a non invasive technique to identify the cut-off values for alcoholic liver fibrosis. J Hepatol 56:S527CrossRef Bensamoun SF, Leclerc GE, Charleux F, et al. (2012) Magnetic resonance elastography (MRE): a non invasive technique to identify the cut-off values for alcoholic liver fibrosis. J Hepatol 56:S527CrossRef
11.
go back to reference Wang J, Malik N, Yin M, et al. (2017) Magnetic resonance elastography is accurate in detecting advanced fibrosis in autoimmune hepatitis. World J Gastroenterol 23:859–868CrossRefPubMedPubMedCentral Wang J, Malik N, Yin M, et al. (2017) Magnetic resonance elastography is accurate in detecting advanced fibrosis in autoimmune hepatitis. World J Gastroenterol 23:859–868CrossRefPubMedPubMedCentral
13.
go back to reference Cui J, Ang B, Haufe W, et al. (2015) Comparative diagnostic accuracy of magnetic resonance elastography vs. eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease: a prospective study. Aliment Pharmacol Ther 41:1271–1280CrossRefPubMedPubMedCentral Cui J, Ang B, Haufe W, et al. (2015) Comparative diagnostic accuracy of magnetic resonance elastography vs. eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease: a prospective study. Aliment Pharmacol Ther 41:1271–1280CrossRefPubMedPubMedCentral
14.
go back to reference Loomba R, Sirlin CB, Ang B, et al. (2015) Ezetimibe for the treatment of nonalcoholic steatohepatitis: assessment by novel magnetic resonance imaging and magnetic resonance elastography in a randomized trial (MOZART trial). Hepatology 61:1239–1250CrossRefPubMedPubMedCentral Loomba R, Sirlin CB, Ang B, et al. (2015) Ezetimibe for the treatment of nonalcoholic steatohepatitis: assessment by novel magnetic resonance imaging and magnetic resonance elastography in a randomized trial (MOZART trial). Hepatology 61:1239–1250CrossRefPubMedPubMedCentral
15.
go back to reference Venkatesh SK, Yin M, Glockner JF, et al. (2008) MR elastography of liver tumors: preliminary results. AJR 190:1534–1540CrossRefPubMed Venkatesh SK, Yin M, Glockner JF, et al. (2008) MR elastography of liver tumors: preliminary results. AJR 190:1534–1540CrossRefPubMed
16.
go back to reference Garteiser P, Doblas S, Daire JL, et al. (2012) MR elastography of liver tumours: value of viscoelastic properties for tumour characterisation. Eur Radiol 22:2169–2177CrossRefPubMed Garteiser P, Doblas S, Daire JL, et al. (2012) MR elastography of liver tumours: value of viscoelastic properties for tumour characterisation. Eur Radiol 22:2169–2177CrossRefPubMed
17.
go back to reference Hennedige TP, Hallinan JT, Leung FP, et al. (2016) Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions. Eur Radiol 26:398–406CrossRefPubMed Hennedige TP, Hallinan JT, Leung FP, et al. (2016) Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions. Eur Radiol 26:398–406CrossRefPubMed
18.
go back to reference Gordic S, Ayache JB, Kennedy P, et al. (2017) Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy. Abdom Radiol 42:1685–1694CrossRef Gordic S, Ayache JB, Kennedy P, et al. (2017) Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy. Abdom Radiol 42:1685–1694CrossRef
19.
go back to reference Barr RG, Ferraioli G, Palmeri ML, et al. (2015) Elastography Assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement. Radiology 276:845–861CrossRefPubMed Barr RG, Ferraioli G, Palmeri ML, et al. (2015) Elastography Assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement. Radiology 276:845–861CrossRefPubMed
22.
go back to reference Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of abdomen. Abdominal Imaging 40:745–759CrossRef Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of abdomen. Abdominal Imaging 40:745–759CrossRef
23.
go back to reference Glaser KJ, Manduca A, Ehman RL (2012) Review of MR elastography applications and recent developments. J Magn Reson Imaging 36:757–774CrossRefPubMed Glaser KJ, Manduca A, Ehman RL (2012) Review of MR elastography applications and recent developments. J Magn Reson Imaging 36:757–774CrossRefPubMed
24.
go back to reference Mariappan YK, Dzyubak B, Glaser KJ, et al. (2017) Application of modified spin-echo-based sequences for hepatic MR elastography: evaluation, comparison with the conventional gradient-echo sequence, and preliminary clinical experience. Radiology 282:390–398CrossRefPubMed Mariappan YK, Dzyubak B, Glaser KJ, et al. (2017) Application of modified spin-echo-based sequences for hepatic MR elastography: evaluation, comparison with the conventional gradient-echo sequence, and preliminary clinical experience. Radiology 282:390–398CrossRefPubMed
26.
go back to reference Tang A, Cloutier G, Szeverenyi NM, et al. (2015) Ultrasound elastography and MR elastography for assessing liver fibrosis: part 1, principles and techniques. AJR 205:22–32CrossRefPubMed Tang A, Cloutier G, Szeverenyi NM, et al. (2015) Ultrasound elastography and MR elastography for assessing liver fibrosis: part 1, principles and techniques. AJR 205:22–32CrossRefPubMed
27.
go back to reference Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of liver. Magn Reson Imaging Clin N Am 22:433–446CrossRefPubMed Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of liver. Magn Reson Imaging Clin N Am 22:433–446CrossRefPubMed
28.
go back to reference Kurbel S, Sven K, Flam J, et al. (2007) Interstitial hydrostatic pressure: a manual for students. Adv Physiol Educ 31:116–117PubMed Kurbel S, Sven K, Flam J, et al. (2007) Interstitial hydrostatic pressure: a manual for students. Adv Physiol Educ 31:116–117PubMed
30.
go back to reference Lazzarini AL, Levine RA, Ploutz-Snyder RJ, et al. (2005) Advances in digital quantification technique enhance discrimination between mild and advanced liver fibrosis in chronic hepatitis C. Liver Int 25:1142–1149CrossRefPubMed Lazzarini AL, Levine RA, Ploutz-Snyder RJ, et al. (2005) Advances in digital quantification technique enhance discrimination between mild and advanced liver fibrosis in chronic hepatitis C. Liver Int 25:1142–1149CrossRefPubMed
31.
32.
go back to reference Singh S, Venkatesh S, Wang Z, et al. (2014) Diagnostic performance of magnetic resonance elastography for the staging of liver fibrosis: a systematic review and collaborative individual participant data meta-analysis. Am J Gastroenterol 109:S144CrossRef Singh S, Venkatesh S, Wang Z, et al. (2014) Diagnostic performance of magnetic resonance elastography for the staging of liver fibrosis: a systematic review and collaborative individual participant data meta-analysis. Am J Gastroenterol 109:S144CrossRef
33.
go back to reference Soloway RD, Baggenstoss AH, Schoenfield LJ, et al. (1971) Observer error and sampling variability tested in evaluation of hepatitis and cirrhosis by liver biopsy. Am J Dig Dis 16:1082–1086CrossRefPubMed Soloway RD, Baggenstoss AH, Schoenfield LJ, et al. (1971) Observer error and sampling variability tested in evaluation of hepatitis and cirrhosis by liver biopsy. Am J Dig Dis 16:1082–1086CrossRefPubMed
34.
go back to reference Maharaj B, Maharaj RJ, Leary WP, et al. (1986) Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver. Lancet 1:523–525CrossRefPubMed Maharaj B, Maharaj RJ, Leary WP, et al. (1986) Sampling variability and its influence on the diagnostic yield of percutaneous needle biopsy of the liver. Lancet 1:523–525CrossRefPubMed
35.
go back to reference Abdi W, Millan J, Mezey E (1979) Sampling variability on percutaneous liver biopsy. Arch Intern Med 139:667–669CrossRefPubMed Abdi W, Millan J, Mezey E (1979) Sampling variability on percutaneous liver biopsy. Arch Intern Med 139:667–669CrossRefPubMed
36.
go back to reference Regev A, Berho M, Jeffers LJ, et al. (2002) Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97:2614–2618CrossRefPubMed Regev A, Berho M, Jeffers LJ, et al. (2002) Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97:2614–2618CrossRefPubMed
37.
38.
go back to reference Loomba R, Cui J, Wolfson T, et al. (2016) Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: a prospective study. Am J Gastroenterol 111:986–994CrossRefPubMedPubMedCentral Loomba R, Cui J, Wolfson T, et al. (2016) Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: a prospective study. Am J Gastroenterol 111:986–994CrossRefPubMedPubMedCentral
39.
40.
go back to reference Babu AS, Wells ML, Teytelboym OM, et al. (2016) Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics 36:1987–2006CrossRef Babu AS, Wells ML, Teytelboym OM, et al. (2016) Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics 36:1987–2006CrossRef
41.
go back to reference Wells ML, Fenstad ER, Poterucha JT, et al. (2016) Imaging findings of congestive hepatopathy. Radiographics 36:1024–1037CrossRefPubMed Wells ML, Fenstad ER, Poterucha JT, et al. (2016) Imaging findings of congestive hepatopathy. Radiographics 36:1024–1037CrossRefPubMed
42.
go back to reference Morisaka H, Motosugi U, Glaser KJ, et al. (2017) Comparison of diagnostic accuracies of two- and three-dimensional MR elastography of the liver. J Magn Reson Imaging 45:1163–1170CrossRefPubMed Morisaka H, Motosugi U, Glaser KJ, et al. (2017) Comparison of diagnostic accuracies of two- and three-dimensional MR elastography of the liver. J Magn Reson Imaging 45:1163–1170CrossRefPubMed
Metadata
Title
Magnetic resonance elastography: beyond liver fibrosis—a case-based pictorial review
Authors
Sudhakar K. Venkatesh
Michael L. Wells
Frank H. Miller
Kartik S. Jhaveri
Alvin C. Silva
Bachir Taouli
Richard L. Ehman
Publication date
01-07-2018
Publisher
Springer US
Published in
Abdominal Radiology / Issue 7/2018
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1383-1

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