Skip to main content
Log in

Comparison of spin-echo echoplanar imaging and gradient recalled echo-based MR elastography at 3 Tesla with and without gadoxetic acid administration

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare spin-echo echoplanar imaging (SE-EPI) and gradient recalled echo (GRE) MR elastography (MRE) at 3 T with and without gadoxetic acid administration.

Methods

We included 84 patients who underwent MRE before and after gadoxetic acid administration, each time using SE-EPI and GRE sequences. Diagnostic performance for predicting clinical liver cirrhosis and high-risk oesophageal varices was assessed using the area under the receiver-operating characteristic curve (AUC). The relationships between T2* and success of MRE, and correlations of liver stiffness (LS) values between the two sequences or before and after gadoxetic acid administration, were investigated.

Results

SE-EPI-MRE resulted in a significantly lower failure rate than GRE-MRE (1.19% vs. 10.71%, P = 0.018). Increased T2* was related to higher probability of successful LS measurement (odds ratio, 1.426; P = 0.004). The AUC of SE-EPI-MRE was comparable to that of GRE-MRE for the detection of clinical liver cirrhosis (0.938 vs. 0.948, P = 0.235) and high-risk oesophageal varices (0.839 vs. 0.752, P = 0.354). LS values were not significantly different before and after gadoxetic acid administration.

Conclusion

SE-EPI-MRE can substitute for GRE-MRE for the detection of clinical liver cirrhosis and high-risk oesophageal varices. SE-EPI-MRE is particularly useful in patients with iron deposition, with lower failure rates than GRE-MRE.

Key Points

LS values are comparable between SE-EPI-MRE and GRE-MRE.

Administration of gadoxetic acid does not influence LS measurement.

The failure rate of SE-EPI-MRE is significantly lower than that of GRE-MRE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

LS:

Liver stiffness

MRE:

Magnetic resonance elastography

SE-EPI:

Spin-echo echoplanar imaging

References

  1. Martínez SM, Crespo G, Navasa M, Forns X (2011) Noninvasive assessment of liver fibrosis. Hepatology 53:325–335

    Article  PubMed  Google Scholar 

  2. Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544–555

    Article  PubMed  PubMed Central  Google Scholar 

  3. Loomba R, Wolfson T, Ang B, Hooker J, Behling C, Peterson M et al (2014) Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study. Hepatology 60:1920–1928

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Yoon JH, Lee JM, Joo I, Lee ES, Sohn JY, Jang SK et al (2014) Hepatic fibrosis: prospective comparison of MR elastography and US shear-wave elastography for evaluation. Radiology 273:772–782

    Article  PubMed  Google Scholar 

  5. Batheja M, Vargas H, Silva AM, Walker F, Chang YH, De Petris G et al (2015) Magnetic resonance elastography (MRE) in assessing hepatic fibrosis: performance in a cohort of patients with histological data. Abdom Imaging 40:760–765

    Article  PubMed  Google Scholar 

  6. Yin M, Glaser KJ, Talwalkar JA, Chen J, Manduca A, Ehman RL (2016) Hepatic MR Elastography: clinical Performance in a Series of 1377 Consecutive Examinations. Radiology 278:114–124

    Article  PubMed  Google Scholar 

  7. Yoshimitsu K, Mitsufuji T, Shinagawa Y, Fujimitsu R, Morita A, Urakawa H et al (2016) MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience. Eur Radiol 26:656–663

    Article  PubMed  Google Scholar 

  8. Huwart L, Sempoux C, Salameh N, Jamart J, Annet L, Sinkus R et al (2007) Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index. Radiology 245:458–466

    Article  PubMed  Google Scholar 

  9. Wang Y, Ganger DR, Levitsky J, Sternick LA, McCarthy RJ, Chen ZE et al (2011) Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusion-weighted imaging. AJR Am J Roentgenol 196:553–561

    Article  PubMed  PubMed Central  Google Scholar 

  10. Park HS, Kim YJ, Yu MH, Choe WH, Jung SI, Jeon HJ (2014) Three-Tesla magnetic resonance elastography for hepatic fibrosis: comparison with diffusion-weighted imaging and gadoxetic acid-enhanced magnetic resonance imaging. World J Gastroenterol 20:17558–17567

    Article  PubMed  PubMed Central  Google Scholar 

  11. Venkatesh SK, Yin M, Takahashi N, Glockner JF, Talwalkar JA, Ehman RL (2015) Non-invasive detection of liver fibrosis: MR imaging features vs. MR elastography. Abdom Imaging 40:766–775

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ronot M, Lambert S, Elkrief L, Doblas S, Rautou PE, Castera L et al (2014) Assessment of portal hypertension and high-risk oesophageal varices with liver and spleen three-dimensional multifrequency MR elastography in liver cirrhosis. Eur Radiol 24:1394–1402

    PubMed  Google Scholar 

  13. Shin SU, Lee JM, Yu MH, Yoon JH, Han JK, Choi BI et al (2014) Prediction of esophageal varices in patients with cirrhosis: usefulness of three-dimensional MR elastography with echo-planar imaging technique. Radiology 272:143–153

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yoon JH, Lee JM, Suh KS, Lee KW, Yi NJ, Lee KB et al (2015) Combined use of MR fat quantification and MR elastography in living liver donors: can it reduce the need for preoperative liver biopsy? Radiology 276:453–464

    Article  PubMed  Google Scholar 

  15. Takamura T, Motosugi U, Ichikawa S, Sano K, Morisaka H, Ichikawa T et al (2016) Usefulness of MR elastography for detecting clinical progression of cirrhosis from child-pugh class A to B in patients with type C viral hepatitis. J Magn Reson Imaging. doi:10.1002/jmri.25182

    PubMed  Google Scholar 

  16. Rump J, Klatt D, Braun J, Warmuth C, Sack I (2007) Fractional encoding of harmonic motions in MR elastography. Magn Reson Med 57:388–395

    Article  PubMed  Google Scholar 

  17. Wagner M, Besa C, Bou Ayache J, Yasar TK, Bane O, Fung M et al (2016) Magnetic resonance elastography of the liver: qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences. Investig Radiol. doi:10.1097/rli.0000000000000269

    Google Scholar 

  18. Motosugi U, Ichikawa T, Sou H, Sano K, Muhi A, Ehman RL et al (2012) Effects of gadoxetic acid on liver elasticity measurement by using magnetic resonance elastography. Magn Reson Imaging 30:128–132

    Article  CAS  PubMed  Google Scholar 

  19. Runge JH, Bohte AE, Verheij J, Terpstra V, Nederveen AJ, van Nieuwkerk KM et al (2014) Comparison of interobserver agreement of magnetic resonance elastography with histopathological staging of liver fibrosis. Abdom Imaging 39:283–290

    Article  PubMed  Google Scholar 

  20. Serai SD, Yin M, Wang H, Ehman RL, Podberesky DJ (2015) Cross-vendor validation of liver magnetic resonance elastography. Abdom Imaging 40:789–794

    Article  PubMed  PubMed Central  Google Scholar 

  21. Yasar TK, Wagner M, Bane O, Besa C, Babb JS, Kannengiesser S et al (2015) Interplatform reproducibility of liver and spleen stiffness measured with MR elastography. J Magn Reson Imaging. doi:10.1002/jmri.25077

    PubMed  PubMed Central  Google Scholar 

  22. Hallinan JT, Alsaif HS, Wee A, Venkatesh SK (2015) Magnetic resonance elastography of liver: influence of intravenous gadolinium administration on measured liver stiffness. Abdom Imaging 40:783–788

    Article  PubMed  Google Scholar 

  23. Stanley DW, Glaser KJ, Yin M, Chen J, Ehman RL (2010) Validity study of spin echo EPI based hepatic MR elastography at 3.0T. 18th Annual Meeting of ISMRM, Stockholm, pp 639

  24. Shi Y, Xia F, Li QJ, Li JH, Yu B, Li Y et al (2016) Magnetic resonance elastography for the evaluation of liver fibrosis in chronic hepatitis B and C by using both gradient-recalled echo and spin-echo echo planar imaging: a prospective study. Am J Gastroenterol. doi:10.1038/ajg.2016.56

    Google Scholar 

  25. Bashir MR, Zhong X, Dale BM, Gupta RT, Boll DT, Merkle EM (2013) Automated patient-tailored screening of the liver for diffuse steatosis and iron overload using MRI. Am J Roentgenol 201:583–588

    Article  Google Scholar 

  26. Zhong X, Nickel MD, Kannengiesser SA, Dale BM, Kiefer B, Bashir MR (2014) Liver fat quantification using a multi-step adaptive fitting approach with multi-echo GRE imaging. Magn Reson Med 72:1353–1365

    Article  PubMed  Google Scholar 

  27. Kim KY, Song JS, Kannengiesser S, Han YM (2015) Hepatic fat quantification using the proton density fat fraction (PDFF): utility of free-drawn-PDFF with a large coverage area. Radiol Med 120:1083–1093

    Article  PubMed  Google Scholar 

  28. Chang W, Lee JM, Yoon JH, Han JK, Choi BI, Lee KB et al (2016) Liver fibrosis staging with MR elastography: comparison of diagnostic performance between patients with chronic hepatitis B and those with other etiologic causes. Radiology. doi:10.1148/radiol.2016150397:150397

    PubMed Central  Google Scholar 

  29. Ichikawa S, Motosugi U, Ichikawa T, Sano K, Morisaka H, Enomoto N et al (2012) Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C. Magn Reson Med Sci 11:291–297

    Article  PubMed  Google Scholar 

  30. Bedossa P, Dargere D, Paradis V (2003) Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 38:1449–1457

    Article  PubMed  Google Scholar 

  31. Huwart L, Salameh N, ter Beek L, Vicaut E, Peeters F, Sinkus R et al (2008) MR elastography of liver fibrosis: preliminary results comparing spin-echo and echo-planar imaging. Eur Radiol 18:2535–2541

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Dr. Takayuki Obata (National Institute of Radiological Sciences, Japan), Dr. Mikio Suga (Chiba University, Japan) and Dr. Takayuki Abe (Siemens Japan SJKK) for their scientific contributions to SE-EPI-MRE. The authors thank the MR radiographers of our unit, Mr. Hyun-Geun Lee, Mr. Dae-Hyun Kim, Mr. Keun-Taek Oh and Mr. Eun-Seong Kim, for technical assistance with MR studies.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ji Soo Song.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Ji Soo Song.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This paper was supported by the Fund of Biomedical Research Institute, Chonbuk National University Hospital

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional review board approval was obtained.

Informed consent

The requirement for written informed consent was waived for review of patient records and images.

Methodology

• retrospective

• observational

• performed at one institution

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, Y.S., Song, J.S., Kannengiesser, S. et al. Comparison of spin-echo echoplanar imaging and gradient recalled echo-based MR elastography at 3 Tesla with and without gadoxetic acid administration. Eur Radiol 27, 4120–4128 (2017). https://doi.org/10.1007/s00330-017-4781-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-017-4781-4

Keywords

Navigation