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Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B

  • Magnetic Resonance
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Abstract

Objectives

We measured the accuracy of magnetic resonance elastography (MRE) for the detection and staging of liver fibrosis in chronic hepatitis B (CHB) and compared it with serum fibrosis markers.

Methods

Prospective comparison of MRE and routine serum fibrosis markers, namely serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), ALT/AST ratio (AAR), AST to platelet ratio index (APRI) and prothrombin index (PI), was performed in 63 consecutive CHB patients who underwent MRE and histological confirmation of liver fibrosis within a 6-month interval. Diagnostic performance of MRE and serum markers for staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4) was compared.

Results

The study group comprised 63 patients (19 female; mean age ± SD, 50 ± 11.9 years). MRE (ρ = 0.94, P < 0.0001), APRI (ρ = 0.42, P = 0.0006), PI (ρ = 0.42, P = 0.0006) and AST (ρ = 0.28, P = 0.028) results correlated significantly with fibrosis stage. MRE was significantly more accurate than serum fibrosis markers for the detection of significant fibrosis (0.99 vs. 0.55–0.73) and cirrhosis (0.98 vs. 0.53–0.77). Sensitivity, specificity, positive predictive and negative predictive values for MRE for significant fibrosis and cirrhosis were 97.4 %, 100 %, 100 % and 96 %, and 100 %, 95.2 %, 91.3 % and 100 %, respectively.

Conclusion

MRE is an accurate non-invasive technique for the detection and staging of liver fibrosis in CHB.

Key Points

• Magnetic resonance elastography is accurate for liver fibrosis detection and staging.

• MR elastography is more accurate than serum tests for staging liver fibrosis.

• MR elastography can potentially replace liver biopsy in chronic hepatitis B.

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Acknowledgement

We acknowledge the support provided by the Individual Research Grant (IRG 1163/2008) from the National Medical Research Council, Singapore.We would like to thank Dr. Richard L. Ehman and the Buzz group, Mayo Clinic, Rochester, MN, USA for their support.

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Authors and Affiliations

  1. Department of Radiology, National University Health System, 5, Lower Kent Ridge Road, Singapore, Singapore

    Sudhakar Kundapur Venkatesh & Gang Wang

  2. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Sudhakar Kundapur Venkatesh

  3. Department of Gastroenterology and Hepatology, National University Health System, 5, Lower Kent Ridge Road, Singapore, Singapore

    Seng Gee Lim

  4. Department of Pathology, National University Health System, 5, Lower Kent Ridge Road, Singapore, Singapore

    Aileen Wee

  5. Radiology, Mayo Clinic, 200, First Street SW, Rochester, MN, 55905, USA

    Sudhakar Kundapur Venkatesh

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  1. Sudhakar Kundapur Venkatesh
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Correspondence to Sudhakar Kundapur Venkatesh.

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Venkatesh, S.K., Wang, G., Lim, S.G. et al. Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol 24, 70–78 (2014). https://doi.org/10.1007/s00330-013-2978-8

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  • DOI: https://doi.org/10.1007/s00330-013-2978-8

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