Pediatric Radiology

, Volume 42, Issue 4, pp 402–409

Pediatric MR elastography of hepatic fibrosis: principles, technique and early clinical experience

  • Larry A. Binkovitz
  • Mounif El-Youssef
  • Kevin J. Glaser
  • Meng Yin
  • Anna K. Binkovitz
  • Richard L. Ehman
Review

Abstract

Numerous pediatric conditions result in hepatic fibrosis. As treatments develop for the underlying disorders, a non-invasive assessment of liver fibrosis would be beneficial as an adjunct or possible replacement for the traditional gold standard, liver biopsy. Magnetic resonance elastography is a noninvasive imaging technique that has been used successfully in adults for identification and assessment of liver fibrosis. This review describes the basic principles of MR elastography as well as the technical aspects specific to children. Clinical pediatric applications, limitations and areas for future research are described.

Keywords

MR elastography Pediatric Liver MRE 

References

  1. 1.
    Bonekamp S, Kamel I, Solga S et al (2009) Can imaging modalities diagnose and stage hepatic fibrosis and cirrhosis accurately? J Hepatol 50:17–35PubMedCrossRefGoogle Scholar
  2. 2.
    Yin M, Chen J, Glaser K et al (2009) Abdominal magnetic resonance elastography. Top Magn Reson Imaging 20:79–87PubMedCrossRefGoogle Scholar
  3. 3.
    Mariappan YK, Glaser KJ, Ehman RL (2010) Magnetic resonance elastography: a review. Clin Anat 23:497–511PubMedCrossRefGoogle Scholar
  4. 4.
    Yin M, Talwalkar JA, Glaser KJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207–1213PubMedCrossRefGoogle Scholar
  5. 5.
    Nobili V, Monti L, Alisi A et al (2011) Transient elastography for assessment of fibrosis in paediatric liver disease. Pediatr Radiol 41(10):1232–1238PubMedCrossRefGoogle Scholar
  6. 6.
    Glaser KJ, Felmlee JP, Manduca A et al (2006) Stiffness-weighted magnetic resonance imaging. Magn Reson Med 55:59–67Google Scholar
  7. 7.
    Yin M, Talwalkar JA, Glaser KJ et al (2011) Dynamic post-prandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease. AJR 197:64–70PubMedCrossRefGoogle Scholar
  8. 8.
    Potter C, Hogan MJ, Henry-Kendjorsky K et al (2011) Safety of pediatric liver biopsy performed by interventional radiologists. J Pediatr Gastroenterol Nutr 53:202–206PubMedCrossRefGoogle Scholar
  9. 9.
    Asbach P, Klatt D, Schlosser B et al (2010) Viscoelasticity-based staging of hepatic fibrosis with multifrequency MR elastography. Radiology 257:80–86PubMedCrossRefGoogle Scholar
  10. 10.
    Huwart L, Sempoux C, Vicaut E et al (2008) Magnetic resonance elastography for the noninvasive staging of liver fibrosis. Clin Gastroenterol Hepatol 135:32–40Google Scholar
  11. 11.
    Huwart L, Sempoux C, Salmeh N et al (2007) Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index. Radiology 245:458–466PubMedCrossRefGoogle Scholar
  12. 12.
    Faria SC, Ganesan K, Mwangi I et al (2009) MR imaging of liver fibrosis: current state of the art. Radiographics 29:1615–1635PubMedCrossRefGoogle Scholar
  13. 13.
    Palmeri ML, Wang MH, Rouze NC et al (2011) Noninvasive evaluation of hepatic fibrosis using acoustic radiation force-based shear stiffness in patients with nonalcoholic fatty liver disease. J Hepatol 55:666–672PubMedCrossRefGoogle Scholar
  14. 14.
    Menten R, Leonard A, Clapuyt P et al (2010) Transient elastography in patients with cystic fibrosis. Pediatr Radiol 40:1231–1235PubMedCrossRefGoogle Scholar
  15. 15.
    Nobili V, Vizzutti F, Arena U et al (2008) Accuracy and reproducibility or transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis. Hepatology 48:442–448PubMedCrossRefGoogle Scholar
  16. 16.
    Chen J, Talwalkar JA, Meng Y et al (2011) Early detection of nonalcoholic steatohepatitis inpatients with nonalcoholic fatty liver disease by using MR elastography. Radiology 259:749–756PubMedCrossRefGoogle Scholar
  17. 17.
    Talwalkar JA, Meng Y, Venkatesh et al (2009) Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR 193:122–127PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Larry A. Binkovitz
    • 1
  • Mounif El-Youssef
    • 2
  • Kevin J. Glaser
    • 1
  • Meng Yin
    • 1
  • Anna K. Binkovitz
    • 3
  • Richard L. Ehman
    • 1
  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Pediatric GastroenterologyMayo ClinicRochesterUSA
  3. 3.Macalaster CollegeSt. PaulUSA

Personalised recommendations