Diffusion-weighted magnetic resonance imaging and micro-RNA in the diagnosis of hepatic fibrosis in chronic hepatitis C virus

Besheer, Tarek; Elalfy, Hatem; El-Maksoud, M. Abd; EL-Razek, Ahmed Abd E L-khalek Abd; Taman, Saher; Zalata, Khaled; Elkashef, Wagdi; Zaghloul, Hosam; Elshahawy, Heba; Raafat, Doaa; Elemshaty, Wafaa; Elsayed, Eman; El‐Gilany, Abdel‐Hady; El-Bendary, Mahmoud

doi:10.3748/wjg.v25.i11.1366

Cited by 29 publications

(15 citation statements)

References 50 publications

(52 reference statements)

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“…Other advantages of CT include the more recent advent of several techniques capable of promoting dose reduction while maintaining acceptable diagnostic quality (such as automatic exposure control and tube current modulation) or enhancing image quality of reduced-dose CT images with filtered back projection and iterative reconstruction techniques [ 25 ]. However, it should be emphasized the important role that MRI has in the non-invasive diagnosis and staging of liver steatosis and fibrosis, especially when considering that in many cases both conditions may coexist [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Higher frequency of hepatic steatosis at CT among COVID-19-positive patients

et al. 2020

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Purpose Recent studies have demonstrated that obesity is significantly associated with increased disease severity, hospitalizations and mortality in COVID-19, with a potential role in the pathogenesis and prevalence in the new pandemic. The association with hepatic steatosis, however, a condition closely related to obesity within the spectrum of systemic metabolic dysfunctions, remains to be elucidated. We aimed to evaluate the frequency of hepatic steatosis as incidentally detected in chest CT examinations of COVID-19 positive patients in comparison to non-infected controls. Methods A retrospective study was performed with 316 patients (204 RT-PCR positive; 112 RT-PCR negative and chest CT negative). Steatosis was measured with placement of a single ROI in the right lobe of the liver (segments VI-VII) and defined as a liver attenuation value ≤ 40 HU. Results The frequency of hepatic steatosis was higher in the RT-PCR positive group in comparison to controls (31.9% vs. 7.1%, p < 0.001). Logistic linear regression analysis showed a 4.7 times odds of steatosis in the COVID-19 positive group as compared to controls after adjusting for age and sex (OR 4.698; 95% IC 2.12-10.41, p < 0.001). Conclusion A significantly higher prevalence of steatosis was found among COVID-19 positive individuals. These findings are in accordance with other recent studies linking obesity and COVID-19 infection, as there is an intricate relationship between liver steatosis, metabolic syndrome and obesity. Further studies are required to confirm if such association remains after accounting for multiple variables, as well as possible relationships with disease severity and worst clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Higher frequency of hepatic steatosis at CT among COVID-19-positive patients

et al. 2020

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“…Although liver biopsy is recommended as the gold standard for the diagnosis and staging of fibrosis, due to its invasive nature and other disadvantages, indirect assessments of liver fibrosis have been developed and are widely used. These include blood-based biomarkers (APRI, FIB-4, enhanced liver fibrosis, Fibro Test) and image-based techniques (US, transient elastography, shear wave elastography, Magnetic resonance elastography) as well as innovative methods that uses combined modalities including advanced magnetic resonance imaging sequences like diffusion-weighted magnetic resonance imaging and genetic testing[ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Gotlieb¹,

Schwartz²,

Zelber‐Sagi³

et al. 2020

WJG

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BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide. The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur. A major challenge is to diagnose advanced fibrosis as early as possible, using simple and non-invasive diagnostics tools. Thrombocytopenia represents advanced fibrosis and portal hypertension (HTN) and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor. However, little is known about the association between longitudinal changes in platelet counts (PTC), when still within the normal range, and the risk of cirrhosis. AIM To explore whether platelet counts trajectories over time, can predict advanced liver fibrosis across the different etiologies of liver diseases. METHODS A nested case-control study utilizing a large computerized database. Cirrhosis cases ( n = 5258) were compared to controls ( n = 15744) matched for age and sex at a ratio of 1:3. All participants had multiple laboratory measurements prior to enrollment. We calculated the trends of PTC, liver enzymes, bilirubin, international normalized ratio, albumin and fibrosis scores (fibrosis-4 and aspartate transaminase-to-platelet ratio index) throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls. The association between PTC, cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated. RESULTS The mean age in both groups was 56 (SD 15.8). Cirrhotic patients were more likely to be smokers, diabetic with chronic kidney disease and had a higher prevalence of HTN. The leading cirrhosis etiologies were viral, alcoholic and fatty liver disease. The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL. This trend was consistent regardless of sex, cirrhosis etiology and was more pronounced in patients who developed varices and ascites. Compared to controls whose values remained in the normal range, in the cirrhosis group aspartate aminotransferase and alanine aminotransferase, increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis. In multivariable regression analysis, a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis (95%CI 1.25-1.35). CONCLUSION In the preceding years before the diagnosis of cirrhosis, there is a progressive decline in PTC, within the normal range, matched to a gradual increase in fibrosis scores.

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“…Consequently, DTI is suitable to depict different stages of fibrosis by imaging the water molecule movement within the space between collagen fibers. 11,12 However, DTI is highly sensitive to breathing and cardiac motion, especially in the left hepatic lobe, which is significantly affected by cardiac motion, making accurate measurements challenging. Perfusion imaging techniques quantify the perfusion parameters of the liver through the use of contrast agents and have been widely investigated.…”

Section: Introductionmentioning

confidence: 99%

Imaging diamagnetic susceptibility of collagen in hepatic fibrosis using susceptibility tensor imaging

Wei

Decker

Nguyen

et al. 2019

Magnetic Resonance in Med

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To characterize the magnetic susceptibility changes of liver fibrosis using susceptibility tensor imaging. Methods: Liver biopsy tissue samples of patients with liver fibrosis were obtained. Three-dimensional gradient-echo and diffusion-weighted images were acquired at 9.4 T. Susceptibility tensors of the samples were calculated using the gradient-echo phase signal acquired at 12 different orientations relative to the B 0 field. Susceptibility anisotropy of the liver collagen fibers was quantified and compared with diffusion anisotropy, measured by DTI. For validation, a comparison was made to histology including hematoxylin and eosin staining, iron staining, and Masson's trichrome staining. Results: Areas with strong diamagnetic susceptibility were observed in the tissue samples forming fibrous patterns. This diamagnetic susceptibility was highly anisotropic. Both the mean magnetic susceptibility and susceptibility anisotropy of collagen fibers exhibited a strong contrast against the surrounding nonfibrotic tissues. The same regions also showed an elevated diffusion anisotropy but with much lower tissue contrast. Masson's trichrome staining identified concentrated collagens in the fibrous regions with high susceptibility anisotropy, and a linear correlation was found between the susceptibility anisotropy and the histology-based staging. Conclusion: Diamagnetic susceptibility indicates the presence of collagen in the fibrotic liver tissues. Mapping magnetic susceptibility anisotropy may serve as a potential marker to quantify collagen fiber changes in patients with liver fibrosis.

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Diffusion-weighted magnetic resonance imaging and micro-RNA in the diagnosis of hepatic fibrosis in chronic hepatitis C virus

Cited by 29 publications

References 50 publications

Higher frequency of hepatic steatosis at CT among COVID-19-positive patients

Higher frequency of hepatic steatosis at CT among COVID-19-positive patients

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Imaging diamagnetic susceptibility of collagen in hepatic fibrosis using susceptibility tensor imaging

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