Joshi Anagha, Muthe Mridula M, Firke Vikrant, Badgujar Harshal
Department of Radiology, Lokmanya Tilak Municipal Medical College, Lokmanya Tilak Municipal General Hospital, Mumbai, India.
SA J Radiol. 2021 May 12;25(1):2072. doi: 10.4102/sajr.v25i1.2072. eCollection 2021.
Magnetic resonance elastography (MRE) is a promising non-invasive technique for the identification and quantification of hepatic fibrosis. This manuscript describes our early experience with MRE for the assessment of the presence and staging of liver fibrosis on a 3T magnetic resonance imaging (MRI) system.
The purpose of this study was to describe the MRE physics, procedure, interpretation and drawbacks, along with a few recommendations as per our experience.
Magnetic resonance elastography was performed on 85 patients with a 3T MRI and the images were analysed both qualitatively and quantitatively. Liver stiffness was assessed by drawing freehand geographic regions of interest on the elastograms to cover the maximum portion of the hepatic parenchyma within the 95% confidence maps on each slice. Correlation with histopathology was performed whenever available.
Of the 80 patients who met the inclusion criteria, 41 patients displayed a normal liver stiffness measurement (LSM) and 39 patients had a raised LSM. In the patients who had a raised LSM, 14 patients had Stage I-II fibrosis, 8 patients had Stage II-III fibrosis, 6 patients had Stage III-IV fibrosis, 4 patients had Stage IV fibrosis or cirrhosis and 7 patients had non-alcoholic steatohepatitis. The mean thickness of the waves increased with increasing stages of fibrosis. The waves became gradually darker medially in patients with normal LSM as compared to the patients with raised LSM. Histopathology with METAVIR scoring was available in 46 patients, which agreed with the MRE findings in all except two patients.
Magnetic resonance elastography is a suitable non-invasive modality for the identification and quantification of hepatic fibrosis.
磁共振弹性成像（MRE）是一种用于识别和量化肝纤维化的有前景的非侵入性技术。本文描述了我们在3T磁共振成像（MRI）系统上使用MRE评估肝纤维化的存在和分期的早期经验。
本研究的目的是描述MRE的物理原理、操作过程、解读方法和缺点，并根据我们的经验提出一些建议。
对85例患者进行了3T MRI的磁共振弹性成像检查，并对图像进行了定性和定量分析。通过在弹性图上徒手绘制感兴趣的地理区域来评估肝脏硬度，以覆盖每个切片上95%置信区间图内肝实质的最大部分。只要可行，就与组织病理学进行相关性分析。
在符合纳入标准的80例患者中，41例患者肝脏硬度测量（LSM）正常，39例患者LSM升高。在LSM升高的患者中，14例患者为I-II期纤维化，8例患者为II-III期纤维化，6例患者为III-IV期纤维化，4例患者为IV期纤维化或肝硬化，7例患者为非酒精性脂肪性肝炎。波的平均厚度随着纤维化分期的增加而增加。与LSM升高的患者相比，LSM正常的患者波在中间逐渐变暗。46例患者可获得METAVIR评分的组织病理学结果，除2例患者外，其余均与MRE结果一致。
磁共振弹性成像是一种适用于识别和量化肝纤维化的非侵入性检查方法。
