Magnetic Resonance Elastography of Liver in Light Chain Amyloidosis

Abstract

In this paper, we present our preliminary findings regarding magnetic resonance elastography (MRE) on the livers of 10 patients with systemic amyloidosis. Mean liver stiffness measurements (LSM) and spleen stiffness measurements (SSM) were obtained. Magnetic resonance imaging (MRI) images were analyzed for the distribution pattern of amyloid deposition. Pearson correlation analysis was performed in order to study the correlation between LSM, SSM, liver span, liver volume, spleen span, spleen volume, serum alkaline phosphatase (ALP), N-terminal pro b-type natriuretic peptide (NT pro BNP), and the kappa and lambda free light chains. An increase in mean LSM was seen in all patients. Pearson correlation analysis showed a statistically significant correlation between LSM and liver volume (r = 0.78, p = 0.007) and kappa chain level (r = 0.65, p = 0.04). Interestingly, LSM did not correlate significantly with SSM (r = 0.45, p = 0.18), liver span (r = 0.57, p = 0.08), or serum ALP (r = 0.60, p = 0.07). However, LSM correlated significantly with serum ALP when corrected for liver volume (partial correlation, r = 0.71, p = 0.03) and NT pro BNP levels (partial correlation, r = 0.68, p = 0.04). MRI review revealed that amyloid deposition in the liver can be diffuse, lobar, or focal. MRE is useful for the evaluation of hepatic amyloidosis and shows increased stiffness in hepatic amyloidosis. MRE has the potential to be a non-invasive quantitative imaging marker for hepatic amyloidosis.

Prognostic significance of serum alkaline phosphatase for all-cause mortality in patients with hypertrophic cardiomyopathy: A cohort of the hospitalized population

“…A study enrolling 10 patients with systemic amyloidosis found Pearson correlation coefficient between serum ALP and NT-proBNP was 0.13 ( P value not significant). 35 Therefore, our preliminary conclusions on the independent predictive effect of ALP may be meaningful, and future studies should add BNP/NT-proBNP or troponin in the univariable and multivariable analysis to further explore its predictive value for all-cause mortality.…”

Diffuse Leberparenchymerkrankungen: (k)ein Buch mit sieben Siegeln

“…Die Elastografie ergibt eine erhöhte Lebersteifigkeit. Diese kann heterogen, diffus oder eher fokal sein [21].…”

Amiloidosis: Desafío en Imagenología

“…Hierro hepático elevado puede ocurrir debido a enfermedad renal en el contexto de amiloidosis renal lo cual es evaluado con MR, con imágenes ponderadas en T2, como una hipointensidad difusa. El amiloide depositado en hígado puede ser evaluado por elastografia por MR, con un incremento de la rigidez, por lo menos dos veces mas de lo normal (58,59).…”