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Technical success rates and reliability of spin-echo echo-planar imaging (SE-EPI) MR elastography in patients with chronic liver disease or liver cirrhosis

  • Magnetic Resonance
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Abstract

Objectives

To determine the technical success rates of MR elastography (MRE) according to established gradient-recalled echo (GRE) and spin-echo echo-planar imaging (SE-EPI) sequences and to compare liver stiffness (LS) values between the sequences during expiratory and inspiratory phases in patients with chronic liver disease or liver cirrhosis.

Methods

One hundred and eight patients who underwent MRE were included in this retrospective study. MRE was performed at 3 T based on both sequences during expiration as well as inspiration. Technical failure of MRE was determined if there was no pixel value with a confidence index higher than 95% and/or no apparent shear waves imaged. LS measurements were performed using free-drawing region of interest. To evaluate clinical factors related to the technical success rate of MRE, we assessed etiology of liver disease, ascites, body habitus, iron deposition, and liver morphology of patients. Statistical analysis was performed with the Wilcoxon test, Bland-Altman plot, independent t test, Mann-Whitney test, and McNemar test.

Results

The technical success rate of MRE in SE-EPI was significantly higher than that of GRE (98.1% vs. 80.7%, p < 0.0001). On the basis of univariate analysis, height, weight, and BMI were significantly associated with failure of MRE (p < 0.05). There was no significant difference in LS values between GRE and SE-EPI (2.82 kPa vs. 2.92 kPa (p > 0.05)). However, the LS values were significantly higher during inspiration than expiration with both GRE and SE-EPI (p < 0.0001).

Conclusion

MRE in SE-EPI during expiratory breath-hold can be used as a reliable examination to evaluate liver fibrosis.

Key Points

• The technical success rate of MR elastography in spin-echo echo-planar imaging (SE-EPI) was significantly higher than that in gradient-recalled echo (GRE) during both the inspiratory and expiratory phases.

• Liver stiffness values were significantly higher during inspiration than during expiration in both GRE and SE-EPI.

• MR elastography in SE-EPI during expiratory breath-hold can be used as a reliable examination in patients with liver fibrosis.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

CLD:

Chronic liver disease

CTP:

Child-Turcotte-Pugh

GRE:

Gradient-recalled echo

HBV:

Hepatitis B virus

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

kPa:

Kilopascals

LC:

Liver cirrhosis

LS:

Liver stiffness

MRE:

Magnetic resonance elastography

ROI:

Region of interest

SE-EPI:

Spin-echo echo-planar imaging

TE:

Transient elastography

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The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea

    Sang Lim Choi, Eun Sun Lee, Ara Ko, Hyun Jeong Park, Sung Bin Park & Byung Ihn Choi

  2. Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea

    Young Youn Cho

  3. Siemens Healthcare GmbH, Erlangen, Germany

    Stephan Kannengiesser

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  1. Sang Lim Choi
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  3. Ara Ko
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Correspondence to Eun Sun Lee.

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The scientific guarantor of this publication is Eun Sun Lee.

Conflict of interest

One of the authors (Stephan Kannengiesser) is an employee of Siemens Healthcare. The rest of the authors declare no relationships with any companies whose products or services may be related to the subject matter of the article.

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No complex statistical methods were necessary for this paper.

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• Retrospective

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Choi, S.L., Lee, E.S., Ko, A. et al. Technical success rates and reliability of spin-echo echo-planar imaging (SE-EPI) MR elastography in patients with chronic liver disease or liver cirrhosis. Eur Radiol 30, 1730–1737 (2020). https://doi.org/10.1007/s00330-019-06496-y

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  • DOI: https://doi.org/10.1007/s00330-019-06496-y

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