National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
From the School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
Invest Radiol. 2023 Jun 1;58(6):413-419. doi: 10.1097/RLI.0000000000000952. Epub 2023 Jan 21.
Three-dimensional (3D) magnetic resonance elastography (MRE) measures liver fibrosis and inflammation but requires several breath-holds that hamper clinical acceptance. The aim of this study was to evaluate the technical and clinical feasibility of a single breath-hold 3D MRE sequence as a means of measuring liver fibrosis and inflammation in obese patients.
From November 2020 to December 2021, subjects were prospectively enrolled and divided into 2 groups. Group 1 included healthy volunteers (n = 10) who served as controls to compare the single breath-hold 3D MRE sequence with a multiple-breath-hold 3D MRE sequence. Group 2 included liver patients (n = 10) who served as participants to evaluate the clinical feasibility of the single breath-hold 3D MRE sequence in measuring liver fibrosis and inflammation. Controls and participants were scanned at 60 Hz mechanical excitation with the single breath-hold 3D MRE sequence to retrieve the magnitude of the complex-valued shear modulus (|G*| [kPa]), the shear wave speed (Cs [m/s]), and the loss modulus (G" [kPa]). The controls were also scanned with a multiple-breath-hold 3D MRE sequence for comparison, and the participants had histopathology (Ishak scores) for correlation with Cs and G".
For the 10 controls, 5 were female, and the mean age and body mass index were 33.1 ± 9.5 years and 23.0 ± 2.1 kg/m 2 , respectively. For the 10 participants, 8 were female, and the mean age and body mass index were 45.1 ± 16.5 years and 33.1 ± 4.0 kg/m 2 (obese range), respectively. All participants were suspected of having nonalcoholic fatty liver disease. Bland-Altman analysis of the comparison in controls shows there are nonsignificant differences in |G*|, Cs, and G" below 6.5%, suggesting good consensus between the 2 sequences. For the participants, Cs and G" correlated significantly with Ishak fibrosis and inflammation grades, respectively ( ρ = 0.95, P < 0.001, and ρ = 0.84, P = 0.002).
The single breath-hold 3D MRE sequence may be effective in measuring liver fibrosis and inflammation in obese patients.
三维（3D）磁共振弹性成像（MRE）可测量肝纤维化和炎症，但需要多次屏气，这阻碍了其临床应用。本研究旨在评估单次屏气 3D MRE 序列作为一种测量肥胖患者肝纤维化和炎症的技术和临床可行性。
2020 年 11 月至 2021 年 12 月，前瞻性纳入受试者并分为两组。第 1 组为健康志愿者（n=10），作为对照组，比较单次屏气 3D MRE 序列与多次屏气 3D MRE 序列。第 2 组为肝脏疾病患者（n=10），作为参与者，评估单次屏气 3D MRE 序列在测量肝纤维化和炎症方面的临床可行性。对照组和参与者均以 60 Hz 机械激发进行单次屏气 3D MRE 序列扫描，以获取复值剪切模量幅度（|G*| [kPa]）、剪切波速度（Cs [m/s]）和损耗模量（G" [kPa]）。对照组还进行了多次屏气 3D MRE 序列扫描进行比较，参与者还进行了肝组织病理学（Ishak 评分）检查，以与 Cs 和 G"进行相关性分析。
10 名对照组中，女性 5 名，平均年龄和体重指数分别为 33.1±9.5 岁和 23.0±2.1 kg/m 2。10 名参与者中，女性 8 名，平均年龄和体重指数分别为 45.1±16.5 岁和 33.1±4.0 kg/m 2（肥胖范围）。所有参与者均怀疑患有非酒精性脂肪性肝病。对照组的 Bland-Altman 分析显示，|G*|、Cs 和 G"在 6.5%以下差异无统计学意义，表明两种序列具有良好的一致性。对于参与者，Cs 和 G"与 Ishak 纤维化和炎症分级分别显著相关（ρ=0.95，P<0.001，和 ρ=0.84，P=0.002）。
单次屏气 3D MRE 序列可能有效测量肥胖患者的肝纤维化和炎症。
