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  • Title: Liver MRI and histological correlates in chronic liver disease on multiphase gadolinium-enhanced 3D gradient echo imaging.
    Author: Martin DR, Lauenstein T, Kalb B, Lurie C, Kitajima H, Sharma P, Salman K, Moreira R, Farris AB, Spivey J, Martinez E, Hanish S, Adsay V.
    Journal: J Magn Reson Imaging; 2012 Aug; 36(2):422-9. PubMed ID: 22566123.
    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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