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Quantitative assessment of disease severity of primary sclerosing cholangitis with T1 mapping and extracellular volume imaging

  • Hepatobiliary
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Abstract

Purpose

Assess the relationship between liver T1 relaxation time and extracellular volume (ECV) fraction and the disease severity of primary sclerosing cholangitis (PSC).

Methods

This retrospective study included 93 patients with PSC and 66 healthy patients in the control group. T1 relaxation times were measured in the right and left lobe, as well as in the area of stricture. T1PSC and ECVPSC were calculated by averaging T1 and ECV of both lobes and stricture site. T1 and ECV were compared between the two groups and according to PSC phenotypes and severity based on Mayo Risk Score (MRS). We also examined the relationship between T1 and ECV with non-invasive measures of fibrosis such as Fibrosis-4 index (FIB-4) and liver stiffness measurement (LSM) by transient elastography.

Results

Mean liver T1 (774 ± 111 ms, p < 0.001) and liver ECV (0.40 ± 0.14, p < 0.05) were significantly higher with both large-duct and small-duct-type PSC which may lack classic imaging findings on MRCP compared to the control group (p < 0.001). T1PSC and ECVPSC showed weak-moderate correlation with LSM, FIB-4, and MRS (p < 0.05). Cut-off values of liver T1 to detect patients in low-risk and high-risk MRS groups were 677 ms (AUC: 0.68, sensitivity: 76%, specificity: 53%, p = 0.03) and 743 ms (AUC: 0.83, sensitivity: 79%, specificity: 76%, p < 0.001), respectively.

Conclusion

T1 relaxation time and ECV fraction can be used for quantitative assessment of disease severity in patients with PSC.

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Authors and Affiliations

  1. Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Blvd Room 0663, Indianapolis, IN, 46202, USA

    Sehnaz Evrimler, Jordan K. Swensson, Temel Tirkes & Fatih Akisik

  2. Department of Radiology, Suleyman Demirel University School of Medicine, East Campus, Cunur, 32260, Isparta, Turkey

    Sehnaz Evrimler

  3. Department of Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle Room 225, Indianapolis, IN, 46202, USA

    Vijay S. Are

  4. Department of Gastroenterology and Hepatology, Indiana University School of Medicine, 550 N University Blvd Room 1710, Indianapolis, IN, 46202, USA

    Raj Vuppalanchi

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  1. Sehnaz Evrimler
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The scientific guarantor of this publication is Fatih Akisik, M.D. 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 source is declared as none.

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Evrimler, S., Swensson, J.K., Are, V.S. et al. Quantitative assessment of disease severity of primary sclerosing cholangitis with T1 mapping and extracellular volume imaging. Abdom Radiol 46, 2433–2443 (2021). https://doi.org/10.1007/s00261-020-02839-2

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