Necro-inflammatory activity grading in chronic viral hepatitis with three-dimensional multifrequency MR elastography

Abstract

The purpose of this study was to assess the diagnostic value of multifrequency MR elastography for grading necro-inflammation in the liver. Fifty participants with chronic hepatitis B or C were recruited for this institutional review board-approved study. Their liver was examined with multifrequency MR elastography. The storage, shear and loss moduli, and the damping ratio were measured at 56 Hz. The multifrequency wave dispersion coefficient of the shear modulus was calculated. The measurements were compared to reference markers of necro-inflammation and fibrosis with Spearman correlations and multiple regression analysis. Diagnostic accuracy was assessed. At multiple regression analysis, necro-inflammation was the only determinant of the multifrequency dispersion coefficient, whereas fibrosis was the only determinant of the storage, loss and shear moduli. The multifrequency dispersion coefficient had the largest AUC for necro-inflammatory activity A ≥ 2 [0.84 (0.71–0.93) vs. storage modulus AUC: 0.65 (0.50–0.79), p = 0.03], whereas the storage modulus had the largest AUC for fibrosis F ≥ 2 [AUC (95% confidence intervals) 0.91 (0.79–0.98)] and cirrhosis F4 [0.97 (0.88–1.00)]. The measurement of the multifrequency dispersion coefficient at three-dimensional MR elastography has the potential to grade liver necro-inflammation in patients with chronic vial hepatitis.

Early diagnosis of hepatic inflammation in Japanese nonalcoholic fatty liver disease patients using 3D MR elastography

“…Only recently, it was reported that the damping ratio (DR) and the loss modulus (G″), an index of liver viscosity obtained during the three-dimensional (3D) MRE complex modulus analysis, might reflect early inflammation in chronic liver diseases. [15][16][17][18][19][20][21][22][23][24] First, this was shown in animal models, including mice with NAFLD, and later it was also reported in human patients with NAFLD. On the other hand, those studies were from the United States and Europe, and the data were obtained primarily from White patients; it remains to be determined whether the findings extend to other ethnic groups.…”

“…However, most of these serum markers and medical devices focus on the quantitative evaluation of liver fibrosis or fat deposition, but not on hepatic inflammation. Only recently, it was reported that the damping ratio (DR) and the loss modulus (G″), an index of liver viscosity obtained during the three‐dimensional (3D) MRE complex modulus analysis, might reflect early inflammation in chronic liver diseases 15–24 . First, this was shown in animal models, including mice with NAFLD, and later it was also reported in human patients with NAFLD.…”

“…First, this was shown in animal models, including mice with NAFLD, and later it was also reported in human patients with NAFLD. On the other hand, those studies were from the United States and Europe, and the data were obtained primarily from White patients; it remains to be determined whether the findings extend to other ethnic groups 15–19,21,23,24 …”

Magnetic resonance elastography of malignant tumors

“…This shear wave frequency dispersion may complicate comparisons between MRE studies performed at different frequencies. However, when probed with multifrequency MRE, the frequency dispersion coefficient may give additional information about tissue structure [61][62][63]. The potential value of multifrequency MRE in cancer remains to be determined.…”

“…In addition to the structural part of tissue stiffness related to matrix deposition, a functional part related to soft tissue water content has been identified [60]. Indeed, several studies have reported elevated stiffness in tissues with inflammation and high interstitial or intravascular pressure [63,76,77].…”