Liver fibrosis: Review of current imaging and MRI quantification techniques

Abstract

5 J. MAGN. RESON. IMAGING 2017;45:1276-1295.

Volumetric multicomponent T1ρrelaxation mapping of the human liver under free breathing at 3T

“…Hence, there is a need to develop noninvasive tests that can be used as early biomarkers to guide clinical management and assess the efficacy of the treatment in clinical trials . Several noninvasive methods, including blood serum markers and various imaging techniques, such as ultrasound, MR elastography, T 1 mapping, and diffusion‐weighted imaging, have been developed in recent years for diagnosing and staging liver fibrosis . The routine clinical imaging protocol includes the assessment of morphological changes related to liver cirrhosis.…”

Transient elastography is an unreliable marker of liver fibrosis in patients with portal vein thrombosis

“…A TE cut‐off value of 13 kPa demonstrates 94% accuracy for the diagnosis of cirrhosis . Diagnostic accuracy of MRE could be even higher at 99% . As demonstrated in the case presented above, the patient had multiple LSMs indicating cirrhosis, despite four negative liver biopsies.…”

“…Transient elastography (TE; FibroScan; Echosens, Paris, France) is one of the most used and validated tools for noninvasive assessment of liver fibrosis based on liver stiffness measurement (LSM). Extrahepatic cholestasis, vascular congestion secondary to cardiac insufficiency, as well as liver damage attributed to acute hepatitis and recent food intake, can reversibly increase liver stiffness and lead to a misdiagnosis of severe liver fibrosis . We here report another cause of false‐positive results of TE, namely portal vein thrombosis possibly resulting in arterial buffer response.…”

Multiorgan, Multimodality Imaging in Cardiometabolic Disease

“…MR elastography techniques may different between fibrotic and non-fibrotic liver in the context of simple steatosis or steatohepatitis 28 . However, MR elastography is extremely sensitive to the confounding effects hepatic iron 29 . Recent improvements to non-contrast multiparametric techniques include T2* correction, which accounts for the T1-shortening effect of hepatic iron that allows for more accurate fibrosis quantification 30 .…”